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

  • Jian Li
  • Wenjie Yang
  • Yawen Cheng
  • Johannes Siegrist
  • Sung-Il Cho
Original Article


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.


Effort–reward imbalance Work stress Validity Job dissatisfaction Healthcare workers 



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.


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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Jian Li
    • 1
    • 5
  • Wenjie Yang
    • 2
  • Yawen Cheng
    • 3
  • Johannes Siegrist
    • 4
  • Sung-Il Cho
    • 1
  1. 1.Department of Epidemiology, School of Public HealthSeoul National UniversitySeoulRepublic of Korea
  2. 2.Department of Epidemiology, College of Public HealthZhengzhou UniversityZhengzhouChina
  3. 3.Institute of Health Policy and Management, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
  4. 4.Department of Medical SociologyUniversity of DuesseldorfDuesseldorfGermany
  5. 5.School of Public HealthKunming Medical CollegeKunmingChina

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