The Relationship between Effort-reward Imbalance and Job Stress among Medical Staff in Beijing

Abstract

Background Medical work is characterized as challenging, tasking and stressful. The effort-reward imbalance (ERI) model suggests that if the organizational environment contributes to ERI, it can negatively affect employees. The investigation of medical staff is an important part of the 6th National Health Services Survey in 2018. The good job satisfaction and work conditions of medical staff are important determinants of service utilization and health improvement for the population. The sense of accomplishment and satisfaction of medical staff is also an important goal of the new healthcare reform. Objective To explore the relationship between ERI and job stress, and provide a reference for reducing the job stress of medical staff. Methods The data for this study were obtained from the results of a sample survey of 4 156 healthcare workers in Beijing during the 6th National Health Services Statistics Survey in 2018. A predictive structural equation model of job stress was constructed and based on ERI questionnaire and job stress questionnaire. Relevant parameters were estimated by using the partial least squares to analyze the relationship between ERI and job stress. Results The valid records for participating in the ERI index calculation were 4 098. According to the ERI index calculation results, 1 333 (32.53%) healthcare workers were in a state of balance between effort and reward, and 2 765 (67.47%) health workers were in a state of imbalance between effort and reward. The results of factor analysis showed that 46.00% of the job stress experienced by medical staff in Beijing can be attributed to ERI model. Extrinsic, intrinsic effort and work reward all had a direct impact on job stress (P<0.001) , the total effect of intrinsic effort was 0.409 (95%CI=0.373 to 0.443) ; the total effect of extrinsic effort was 0.583 (95%CI=0.559 to 0.606) ; the total effect of work reward was -0.199 (95%CI=-0.227 to -0.171) . In addition, the intrinsic effort mediated the impact of extrinsic effort and work rewards on job stress. Conclusion The results of the study support the hypothesis that ERI is an important source of job stress for medical staff in Beijing. Based on the evidence that the intrinsic effort has the greatest impact on job stress, the relevant management system should be improved by health administration and medical institutions to address ERI and reduce the job stress of medical staff.

Keywords

• medical staff|occupational stress|effort-reward imbalance|structural equation model|partial least square method|beijing