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J Siegrist

Publications and source records attributed to J Siegrist.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Non-reciprocal social exchange is a health risk: a medical sociological research model].

Contrary to a reductionist disease concept prevailing in molecular medicine, a systemic disease concept is emphasised in this sociopsychosomatic approach towards analysing disease as a result of disturbed social exchange among people. More precisely, violations of the norms of social reciprocity in core social roles in adult life, in particular in the work role, are assumed to trigger stressful experience with adverse long-term consequences for health. The model of effort-reward imbalance at work provides an illustrative case of nonreciprocal social exchange. It defines distinct conditions in which an imbalance between high efforts spent and low rewards received in turn is maintained by the workers. In this model social rewards are analysed in terms of money, esteem and promotion prospect including job security. The contribution summarises results from 6 international prospective and cross-sectional epidemiological investigations testing the model of effort-reward imbalance at work with regard to different health indicators (especially coronary heart disease, hypertension, depression, alcohol dependence). In all instances an elevated risk of illness is observed among those who experience non-reciprocal social exchange in terms of effort-reward imbalance at work, compared to people who are free from this type of stressful experience. Results are derived from logistic regression analysis adjusting for the effects of potential confounders. In view of this evidence the medical sociological approach outlined here may be helpful in contrasting a reductionist concept of disease with a systemic concept centred around the sociopsychosomatic aspects of human health and disease.

Adaptation, Psychological↗
PubMed2001

[Psychosocial factors influencing development and course of coronary heart disease].

BACKGROUND: An important role of psychosocial factors in influencing the development and course of coronary heart disease is increasingly recognized. This article summarizes current evidence with regard to five particularly well established psychosocial constructs. PSYCHOSOCIAL CONSTRUCTS: These are 1. hostility/overcommitment, 2. depression, vital exhaustion, 3. social support, and a stressful psychosocial work environment, 4. in terms of the demand-control model and 5. in terms of the effort-reward imbalance model. RESULTS OF STUDIES: Selected empirical results from epidemiologic, clinical and experimental studies are described which indicate that the relative risk associated with each one of these factors is of a comparable magnitude for the estimation of future coronary heart disease as established behavioral risk factors such as cigarette smoking or physical exercise. CONCLUSIONS: Suggestions concerning a common stress-physiological mechanism underlying chronic socio-emotional stress, as identified by the five constructs, are given. In its final part, the paper briefly discusses practical implications of this new information for the cardiologist's patient-centered work and, most importantly, for improved measures of primary and secondary prevention.

Coronary Disease↗
PubMed2001

[Evaluation of health policy intervention on the community level--the "Neighborhood Coordination of Health and Social Care" Model Project in North Rhine-Westphalia].

Between October 1995 and December 1998 the pilot project 'Local Coordination of Health and Social Care' was conducted in 28 communities of the state of North Rhine-Westphalia. The project has been evaluated by two university research teams. The aim of the project was basically to establish new structures of health planning and coordination at the community level, in order to improve health reporting and health care as well as health promotion. To realize this aim round tables, working groups and project-offices were implemented in the communities. The evaluation was focused on the following question: What were the conditions (structures) and processes that influenced the project outcomes? Qualitative and quantitative methods were applied (interviews, standardised self-administered questionnaires, analyses of documents) to this end. Evaluation of structures showed that most communities succeeded in integrating relevant health policy actors into the newly created round tables and working groups. Working climate and achievements were evaluated favourably by most of the involved actors. All communities succeeded in developing and enacting recommendations for programmes, and about 40% of these programmes were implemented during the project. The probability of programme implementation was particularly high if the programme was based on reliable local data and if execution was effected only on the community level. The possibly beneficial effects on health care and welfare produced by the new programmes could not be assessed within the short project period. The paper concludes with a brief discussion of practical consequences for future health policy at community level.

Community Health Centers↗
PubMed2001

Psychosocial work characteristics and self rated health in four post-communist countries.

STUDY OBJECTIVES: To examine whether psychosocial factors at work are related to self rated health in post-communist countries. DESIGN AND SETTINGS: Random samples of men and women in five communities in four countries were sent a postal questionnaire (Poland, Czech Republic and Lithuania) or were invited to an interview (Hungary). Working subjects (n=3941) reported their self rated health in the past 12 months (5 point scale), their socioeconomic circumstances, perceived control over life, and the following aspects of the psychosocial work environment: job control, job demand, job variety, social support, and effort and reward at work (to calculate a ratio of effort/reward imbalance). As the results did not differ by country, pooled analyses were performed. Odds ratios of poor or very poor health ("poor health") were estimated for a 1 SD increase in the scores of work related factors. MAIN RESULTS: The overall prevalence of poor health was 6% in men and 7% in women. After controlling for age, sex and community, all work related factors were associated with poor health (p<0.05). After further adjustment for perceived control, only two work related factors remained associated with poor health; the odds ratios (95% confidence intervals) for 1 SD increase in the effort/reward ratio (log transformed) and job variety were 1.51 (1.29, 1.78) and 0.82 (0.73, 1.00), respectively. Further adjustment for all work related factors did not change these estimates. There were no interactions between individual work related factors, but the effects of job control and social support at work differed by marital status, and the odds ratio of job demand increased with increasing education. CONCLUSIONS: The continuous measure of effort/reward imbalance at work was a powerful determinant of self rated health in these post-communist populations. Although the cross sectional design does not allow firm conclusions as to causality, this study suggests that the effect of the psychosocial work environment is not confined to Western populations.

Adolescent↗
PubMed2001

Association between job stress and depression among Japanese employees threatened by job loss in a comparison between two complementary job-stress models.

OBJECTIVES: This study compared the separate effects produced by two complementary stress models--the job demand-control model and the effort-reward imbalance model--on depression among employees threatened by job loss. METHODS: A cross-sectional analysis was conducted to examine these associations among 190 male and female employees who responded to a self-administered questionnaire in a small Japanese plant with economic hardship. The employees were engaged in 2 job types--direct assembly line and indirect supportive tasks--and the latter was threatened by job loss because of downsizing. Independent variables were measured by the Japanese versions of Karasek's demand-control questionnaire and Siegrist's effort-reward imbalance questionnaire. Depression was assessed by the Center for Epidemiologic Studies Depression Scale. RESULTS: The employees with indirect supportive tasks (target for downsizing) were more likely to have depressive symptoms than direct assembly-line workers. Job strain, a combination of high demand and low control at work, was more frequent among the latter, while the combination of high effort and low reward was more frequent among the former. After adjustment for work environment factors, low control [odds ratio (OR) 4.7], effort reward imbalance (OR 4.1), and overcommitment (the person characteristic included in the effort-reward imbalance model) (OR 2.6) were independently related to depression. There is some indication that these effects were particularly strong in the subgroup suffering from potential job loss. CONCLUSIONS: This study confirms that the 2 job stress models identify different aspects of stressful job conditions. Moreover, effort-reward imbalance and low control at work are both associated with symptoms of depression.

Adult↗
PubMed2000

Psychosocial work environment and the risk of coronary heart disease.

OBJECTIVES: Remarkable changes in the working situation have led to the increasing importance of psychomentally and socio-emotionally demanding conditions at work. With the help of theoretical models, those highly prevalent psychosocial work environments were conceptualized which influence the risk of coronary heart disease by enhanced activation of the autonomic nervous system. One of the most prominent theoretical approaches, the job strain model, and a more recent approach, the effort-reward imbalance model, are discussed in the paper. EMPIRICAL EVIDENCE: Findings from prospective and cross-sectional studies indicate that job strain and effort-reward imbalance at work define specific conditions of chronic work stress that are associated with an elevated risk of coronary heart disease (CHD). Respective multivariate odds-ratios range from 1.2 to 5.0 with respect to job strain, and from 1.5 to 6.1 with respect to effort-reward imbalance. These associations are explained neither by established behavioral or biomedical risk factors nor by physical and chemical hazards at work, rather they define independent, new work-related risk conditions. There is additional evidence that effort-reward imbalance may mediate the association of some traditional occupational exposures, such as shift work, with cardiovascular risk: in a cross-sectional study, prevalence odds ratios of hypertension and atherogenic lipids attributable to effort-reward imbalance were relatively highest among shiftworkers as compared to daytime workers. Preliminary results from intervention programs based on the theoretical models document favorable effects on health. CONCLUSIONS: Information derived from theoretical models on psychosocial work environment may help to better identify populations at risk and to develop and apply specific, theory-guided preventive activities in the future.

Coronary Disease↗
PubMed2000

Place, social exchange and health: proposed sociological framework.

A sociological framework is proposed to better understand how spatial characteristics translate into people's physical and psychosocial conditions that are relevant to their health. In particular, high susceptibility to poor health among specific adult population groups is analyzed in terms of exclusion from or inadequate participation in a society's structure of opportunities. Acquisition of, and agency through, core social roles, such as the work role, the family and marital role, and civic roles, are essential prerequisites for successful personal self-regulation in adult life, strengthening a sense of self-esteem, self-efficacy, and belonging (self-integration). It is argued that exclusion from, or loss of core social roles, threats to their continuity and confinement to non-reciprocal exchange impair personal self-regulation and trigger a state of 'social reward deficiency'. This state, in turn, elicits prolonged stressful experience, and it may reinforce a person's craving for stress-relieving, potentially addictive health-damaging behavior. This framework is applied to the explanation of the life expectancy gap between Western and Central/Eastern European countries. Although most of the epidemiological evidence reviewed in support of this approach originates from investigations that were conducted in western countries several results reported in the collection of articles published in this Special Issue of Social Science and Medicine are in line with the proposed framework.

Adult↗
PubMed2000

Job strain, effort-reward imbalance and employee well-being: a large-scale cross-sectional study.

This study investigated the effects of the Job Demand-Control (JD-C) Model and the Effort-Reward Imbalance (ERI) Model on employee well-being. A cross-sectional survey was conducted comprising a large representative sample of 11,636 employed Dutch men and women. Logistic regression analyses were used. Controlling for job sector, demographic characteristics (including educational level) and managerial position, employees reporting high job demands (i.e. psychological and physical demands) and low job control had elevated risks of emotional exhaustion, psychosomatic and physical health complaints and job dissatisfaction (odds ratios ranged from 2.89 to 10.94). Odds ratios were generally higher in employees reporting both high (psychological and physical) efforts and low rewards (i.e. poor salary, job insecurity and low work support): they ranged from 3.23 to 15.43. Furthermore, overcommitted people had higher risks of poor well-being due to a high effort-low reward mismatch (ORs: 3.57-20.81) than their less committed counterparts (ORs: 3.01-12.71). Finally, high efforts and low occupational rewards were stronger predictors of poor well-being than low job control when both job stress models were simultaneously adjusted. In conclusion, our findings show independent cumulative effects of both the JD-C Model and the ERI Model on employee well-being and are not significantly different in men and women as well as in young and old people. In particular, high (psychological and physical) efforts and low rewards adversely affected employee well-being. Preliminary findings also indicate excess risks of poor well-being in overcommitted persons suffering from high cost--low gain conditions at work.

Adolescent↗
PubMed2000

Stress prevention in bus drivers: evaluation of 13 natural experiments.

The research aim was to select, compare, and analyze interventions and preventive actions from international bus companies to decrease bus drivers' occupational stress and sickness absenteeism. Through networking, international surveys, and literature study, 13 "natural experiments" were identified with an acceptable research design rating. Interventions were both work and person directed. Principles of worker participation were often followed. The variety in intervention programs, outcome measures, case evaluations, and methodological flaws makes it difficult to present a general picture of program effectiveness. However, analyses on more objective and more subjective outcomes do point at positive effects. This study suggests that stress prevention that combines adequate interventions and proper implementation may be beneficial to both the employee and the company.

Cross-Cultural Comparison↗
PubMed2000

Effort-reward imbalance and burnout among nurses.

This study among a sample of 204 German nurses tested the hypothesis that an imbalance of high extrinsic efforts spent (i.e. job demands) and low extrinsic rewards obtained (e.g. poor promotion prospects) are associated with the burnout syndrome: the depletion of nurses' emotional resources. The results of a series of analyses of variances confirmed this hypothesis, by showing that those nurses who experienced an effort-reward imbalance (ERI) reported higher levels on two of the three core dimensions of burnout (i.e. emotional exhaustion and depersonalization) than those who did not experience such an imbalance. Moreover - as additionally hypothesized - significant interaction effects indicated that burnout (i.e. emotional exhaustion and reduced personal accomplishment) was particularly prevalent among those nurses who experienced ERI and put relatively high intrinsic effort into their jobs, as reflected by their strong tendency to be personally in control over job conditions.

Adult↗
PubMed2000

[Psychometric properties of the French version of the Effort-Reward Imbalance model].

BACKGROUND: Two main models are currently used to evaluate psychosocial factors at work: the Job Strain model developed by Karasek and the Effort-Reward Imbalance model. A French version of the first model has been validated for the dimensions of psychological demands and decision latitude. As regards the second one evaluating three dimensions (extrinsic effort, reward, and intrinsic effort), there are several versions in different languages, but until recently there was no validated French version. The objective of this study was to explore the psychometric properties of the French version of the Effort-Reward Imbalance model in terms of internal consistency, factorial validity, and discriminant validity. METHODS: The present study was based on the GAZEL cohort and included the 10 174 subjects who were working at the French national electric and gas company (EDF-GDF) and answered the questionnaire in 1998. A French version of Effort-Reward Imbalance was included in this questionnaire. This version was obtained by a standard forward/backward translation procedure. RESULTS: Internal consistency was satisfactory for the three scales of extrinsic effort, reward, and intrinsic effort: Cronbach's Alpha coefficients higher than 0.7 were observed. A one-factor solution was retained for the factor analysis of the scale of extrinsic effort. A three-factor solution was retained for the factor analysis of reward, and these dimensions were interpreted as the factor analysis of intrinsic effort did not support the expected four-dimension structure. The analysis of discriminant validity displayed significant associations between measures of Effort-Reward Imbalance and the variables of sex, age, education level, and occupational grade. CONCLUSION: This study is the first one supporting satisfactory psychometric properties of the French version of the Effort-Reward Imbalance model. However, the factorial validity of intrinsic effort could be questioned. Furthermore, as most previous studies were based on male samples working in specific occupations, the present one is also one of the first to show strong associations between measures of this model and social class variables in a population of men and women employed in various occupations.

Adult↗
PubMed1999

Overcommitment predicts restenosis after coronary angioplasty in cardiac patients.

The objective of this study is to examine the role of a particular stress-enhancing psychosocial risk factor, termed overcommitment, in predicting restenosis after successful percutaneous transluminal coronary angioplasty (PTCA). Overcommitment defines a personal pattern of coping with demands characterized by excessive striving in combination with a strong desire of being approved and esteemed. One hundred six consecutive male patients with coronary artery disease who underwent PTCA were followed over a mean of 12 months. The restenosis rate as defined by quantitative angiography was 34%. Multivariate analysis revealed independent effects of high density lipoprotein cholesterol (odds ratio [OR] 3.19), age (OR 3.43), and overcommitment (OR 2.86) on risk of restenosis. In conclusion, a stress-enhancing psychosocial person characteristic termed overcommitment acts as an independent predictor of coronary restenosis after PTCA. As overcommitment is subject to cognitive-behavioral intervention, results have implications for a more comprehensive approach to secondary prevention in cardiac patients.

Journal Article↗
PubMed1999

Does a stressful psychosocial work environment mediate the effects of shift work on cardiovascular risk factors?

OBJECTIVES: Associations between shift work, chronic psychosocial work stress, and 2 important cardiovascular risk factors, hypertension and atherogenic lipids were studied. The hypothesis was tested that psychosocial work stress, as defined by the model of effort-reward imbalance, mediates the effects of shift work on cardiovascular risk. METHODS: Altogether 2288 male participants aged 30-55 years in the baseline screening of the Swedish WOLF (work organization, lipids, and fibrinogen) study underwent a clinical examination and answered a standardized questionnaire measuring shiftwork schedules, effort-reward imbalance at work, and health-adverse behavior. RESULTS: In addition to the direct effects of shift work on cardiovascular risk, mediating effects of effort-reward imbalance at work were found. The respective odds ratios (OR) ranged from 2.18 to 2.27 for hypertension and from 1.34 to 1.45 for atherogenic lipids. While the effects remained significant after extensive confounder control concerning hypertension, part of the observed effect on atherogenic lipids was due to behavioral influences. CONCLUSIONS: Despite obvious limitations, the results indicated that a stressful psychosocial work environment acts as a mediator of health-adverse effects of shift work on hypertension and, partly, atherogenic lipids. In terms of occupational health the findings call for a more comprehensive assessment of the health risks associated with shift work.

Adult↗