Abstract
We examined the association between depression symptoms and job stress based on the Demand–Control–Support model among workers employed in Japanese eldercare institutions. We randomly selected 197 eldercare institutions and invited workers to participate in a questionnaire survey. Depression symptom prevalence and severity were evaluated using the Center for Epidemiologic Studies Depression (CES-D) Scale (≥ 16 = high score). Job stress was assessed using the Job Content Questionnaire based on job Demand–Control–Support. A total of 2,727 workers agreed to participate. In total, 1,740 valid responses were obtained from 434 males and 1,306 females. Approximately 44.9% had high CES-D scores. Workers with long working hours had high and low scores of psychological job demand and social support, respectively. Those who exhibited high CES-D scores had significantly higher psychological job demand scores and lower decision latitude and social support scores. A positive correlation was found between psychological job demand and CES-D scores. By contrast, a negative correlation was found between decision latitude and CES-D scores and between the social support scores and CES-D scores. Employers and employees should be mindful of the risks associated with prolonged work hours to prevent depression. Moreover, special attention should be paid to workers with substantial psychological job demands, low decision latitude, and low social support, as these workers constitute a high-risk group.
Similar content being viewed by others
Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
References
Arsalani, N., Fallahi-Khoshknab, M., Josephson, M., & Lagerström, M. (2014). Musculoskeletal disorders and working conditions among Iranian nursing personnel. International Journal of Occupational Safety and Ergonomics, 20(4), 671–680. https://doi.org/10.1080/10803548.2014.11077073
Chan, A., Malhotra, C., Malhotra, R., Rush, A. J., & Østbye, T. (2013). Health impacts of caregiving for older adults with functional limitations: Results from the Singapore survey on informal caregiving. Journal of Aging and Health, 25(6), 998–1012. https://doi.org/10.1177/0898264313494801
Damiani, G., Farelli, V., Anselmi, A., Sicuro, L., Solipaca, A., Burgio, A., Iezzi, D. F., & Ricciardi, W. (2011). Patterns of long term care in 29 European countries: Evidence from an exploratory study. BMC Health Services Research, 11, 316. https://doi.org/10.1186/1472-6963-11-316
D’Souza, R. M., Strazdins, L., Broom, D. H., Rodgers, B., & Berry, H. L. (2006). Work demands, job insecurity and sickness absence from work. How productive is the new, flexible labour force? Australian and New Zealand Journal of Public Health, 30(3), 205–212. https://doi.org/10.1111/j.1467-842x.2006.tb00859.x
Eaton, W. W., Martins, S. S., Nestadt, G., Bienvenu, O. J., Clarke, D., & Alexandre, P. (2008). The burden of mental disorders. Epidemiologic Reviews, 30, 1–14. https://doi.org/10.1093/epirev/mxn011
Fujisawa, R., & Colombo, F. (2009). The long-term care workforce: overview and strategies to adapt supply to a growing demand. OECD Health Working Papers No.44. https://doi.org/10.1787/225350638472
Fushimi, M. (2015). Prevalence of depressive symptoms and related factors in Japanese employees: A comparative study between surveys from 2007 and 2010. Psychiatry Journal, 2015, 537073. https://doi.org/10.1155/2015/537073
Fushimi, M. (2019). Depressive symptoms and related factors among workers in care institutions for older persons in Japan: A cross-sectional study. European Geriatric Medicine, 10(6), 957–964. https://doi.org/10.1007/s41999-019-00241-w
Fushimi, M., Shimizu, T., Saito, S., Kudo, Y., Seki, M., & Murata, K. (2010). Prevalence of and risk factors for psychological distress among employees in Japan. Public Health, 124(12), 713–715. https://doi.org/10.1016/j.puhe.2010.07.010
Fushimi, M., Saito, S., Shimizu, T., Kudo, Y., Seki, M., & Murata, K. (2012). Prevalence of psychological distress, as measured by the Kessler 6 (K6), and related factors in Japanese employees. Community Mental Health Journal, 48(3), 328–335. https://doi.org/10.1007/s10597-011-9416-7
Fushimi, M., Saito, S., & Shimizu, T. (2013). Prevalence of depressive symptoms and related factors in Japanese employees as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Community Mental Health Journal, 49(2), 236–242. https://doi.org/10.1007/s10597-012-9542-x
Gospel, H. (2015). Varieties of qualifications, training, and skills in long-term care: A German, Japanese, and UK comparison. Human Resource Management, 54(5), 833–850. https://doi.org/10.1002/hrm.21714
Häusser, J. A., Mojzisch, A., Niesel, M., & Schulz-Hardt, S. (2010). Ten years on: A review of recent research on the job demand—Control (-Support) model and psychological well-being. Work and Stress, 24(1), 1–35. https://doi.org/10.1080/02678371003683747
Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., Laschinger, H. K., & North, N. (2012). Nurse turnover: A literature review—An update. International Journal of Nursing Studies, 49(7), 887–905. https://doi.org/10.1016/j.ijnurstu.2011.10.001
Hilton, M. F., Whiteford, H. A., Sheridan, J. S., Cleary, C. M., Chant, D. C., Wang, P. S., & Kessler, R. C. (2008). The prevalence of psychological distress in employees and associated occupational risk factors. Journal of Occupational and Environmental Medicine, 50(7), 746–757. https://doi.org/10.1097/JOM.0b013e31817e9171
Holst Pedersen, L. H., Brynningsen, P., Foss, C. H., Gregersen, M., Barat, I., & Damsgaard, E. M. (2018). Avoidable readmissions seem to be reduced by early follow-up visits for geriatric patients discharged from hospital. European Geriatric Medicine, 9(5), 613–621. https://doi.org/10.1007/s41999-018-0078-7
Honda, A., Date, Y., Abe, Y., Aoyagi, K., & Honda, S. (2014). Work-related stress, caregiver role, and depressive symptoms among Japanese workers. Safety and Health at Work, 5(1), 7–12. https://doi.org/10.1016/j.shaw.2013.11.002
Ikeda-Sonoda, S., Ichihara, N., Okochi, J., Takahashi, A., & Miyata, H. (2020). Association of care workers’ job satisfaction and global happiness with change of functional performance of severely disabled elderly residents in nursing homes: A cohort and questionnaire study in Japan. British Medical Journal Open, 10(10), e033937. https://doi.org/10.1136/bmjopen-2019-033937
Iwata, N., Okuyama, Y., Kawakami, Y., & Saito, K. (1989). Prevalence of depressive symptoms in a Japanese occupational setting: A preliminary study. American Journal of Public Health, 79(11), 1486–1489. https://doi.org/10.2105/ajph.79.11.1486
Jalilian, H., Shouroki, F. K., Azmoon, H., Rostamabadi, A., & Choobineh, A. (2019). Relationship between job stress and fatigue based on job demand-control-support model in hospital nurses. International Journal of Preventive Medicine, 10, 56. https://doi.org/10.4103/ijpvm.IJPVM_178_17
Johnson, S., Cooper, C., Cartwright, S., Donald, I., Taylor, P., & Millet, C. (2005). The experience of work-related stress across occupations. Journal of Managerial Psychology, 20(2), 178–187. https://doi.org/10.1108/02683940510579803
Joling, K. J., Smit, F., van Marwijk, H. W., van der Horst, H. E., Scheltens, P., Schulz, R., & van Hout, H. P. (2012). Identifying target groups for the prevention of depression among caregivers of dementia patients. International Psychogeriatrics, 24(2), 298–306. https://doi.org/10.1017/S1041610211001633
Kaneko, R., Ishikawa, A., Ishii, F., Sasai, T., Iwasawa, M., Mita, F., & Moriizumi, R. (2008). Population projections for Japan: 2006–2055 Outline of results, methods, and assumptions. The Japanese Journal of Population, 6(1), 76–114.
Karasek, R. A. (1985). Job content questionnaire and User’s guide. University of Massachusetts.
Karasek, R., & Theorell, T. (1992). Healthy work: Stress, productivity, and the reconstruction of working life. Basic Books.
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. Journal of Occupational Health Psychology, 3(4), 322–355. https://doi.org/10.1037//1076-8998.3.4.322
Kataoka, S., Kitamura, K., Kataoka, Y., & Yamamoto, Y. (2021). Depressive symptoms and their associated factors in nursery school teachers: A multicenter cross-sectional study. Cureus, 13(7), e16545. https://doi.org/10.7759/cureus.16545
Kawakami, N., Kobayashi, F., Araki, S., Haratani, T., & Furui, H. (1995). Assessment of job stress dimensions based on the job demands- control model of employees of telecommunication and electric power companies in Japan: Reliability and validity of the Japanese version of the Job Content Questionnaire. International Journal of Behavioral Medicine, 2(4), 358–375. https://doi.org/10.1207/s15327558ijbm0204_5
Li, A., Shaffer, J., & Bagger, J. (2015). The psychological well-being of disability caregivers: Examining the roles of family strain, family-to-work conflict, and perceived supervisor support. Journal of Occupational Health Psychology, 20(1), 40–49. https://doi.org/10.1037/a0037878
Margallo-Lana, M., Reichelt, K., Hayes, P., Lee, L., Fossey, J., O’Brien, J., & Ballard, C. (2001). Longitudinal comparison of depression, coping, and turnover among NHS and private sector staff caring for people with dementia. BMJ, 322(7289), 769–770. https://doi.org/10.1136/bmj.322.7289.769
Menzel, N. N. (2007). Psychosocial factors in musculoskeletal disorders. Critical Care Nursing Clinics of North America, 19(2), 145–153. https://doi.org/10.1016/j.ccell.2007.02.006
Moustaka, A., & Constantinidis, T. C. (2010). Sources and effects of work-related stress in nursing. Health Science Journal, 4, 210–216.
Nieuwenhuijsen, K., Bruinvels, D., & Frings-Dresen, M. (2010). Psychosocial work environment and stress-related disorders, a systematic review. Occupational Medicine, 60(4), 277–286. https://doi.org/10.1093/occmed/kqq081
Nishino, T. (2017). Quantitative properties of the macro supply and demand structure for care facilities for elderly in Japan. International Journal of Environmental Research and Public Health, 14(12), 1489. https://doi.org/10.3390/ijerph14121489
Oshio, T. (2014). The association between involvement in family caregiving and mental health among middle-aged adults in Japan. Social Science and Medicine, 115, 121–129. https://doi.org/10.1016/j.socscimed.2014.06.016
Peltzer, K., Shisana, O., Zuma, K., Van Wyk, B., & Zungu-Dirwayi, N. (2009). Job stress, job satisfaction and stress-related illnesses among South African educators. Stress and Health, 25(3), 247–257. https://doi.org/10.1002/smi.1244
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
Saremi, M., & Fallah, M. R. (2013). Subjective fatigue and medical errors among nurses in an educational hospital. Iran Occupational Health, 10, 1–8.
Schneider, U., Trukeschitz, B., Mühlmann, R., & Ponocny, I. (2013). ‘Do I stay or do I go?’—Job change and labor market exit intentions of employees providing informal care to older adults. Health Economics, 22(10), 1230–1249. https://doi.org/10.1002/hec.2880
Squires, J. E., Hoben, M., Linklater, S., Carleton, H. L., Graham, N., & Estabrooks, C. A. (2015). Job satisfaction among care aides in residential long-term care: A systematic review of contributing factors, both individual and organizational. Nursing Research and Practice, 1–24. https://doi.org/10.1155/2015/157924
Suzumura, M., Fushiki, Y., Kobayashi, K., Oura, A., Suzumura, S., Yamashita, M., & Mori, M. (2013). A cross-sectional study on association of work environment, coping style, and other risk factors with depression among caregivers in group homes in Japan. Industrial Health, 51(4), 417–423. https://doi.org/10.2486/indhealth.2012-0204
Tanaka, O., Maeda, E., Fushimi, M., Iwata, T., Shimizu, T., Saito, S., & Murata, K. (2017). Precarious employment is not associated with increased depressive symptoms: A cross-sectional study in care service workers of Japan. Tohoku Journal of Experimental Medicine, 243(1), 19–26. https://doi.org/10.1620/tjem.243.19
Teraoka, M., & Kyougoku, M. (2015). Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: A study using structural equation modeling. PeerJ, 3(3), e1389. https://doi.org/10.7717/peerj.1389
Thirumakkal, M. (2015). A study on role of occupational stress on employees productivity. International Journal of Management, 6, 560–572.
Tsuno, N., & Honma, A. (2009). Ageing in Asia—the Japan experience. Ageing International, 34, 1–14. https://doi.org/10.1007/s12126-009-9032-9
Van den Heede, K., Bouckaert, N., & Van de Voorde, C. (2019). The impact of an ageing population on the required hospital capacity: Results from forecast analysis on administrative data. European Geriatric Medicine, 10(5), 697–705. https://doi.org/10.1007/s41999-019-00219-8
Van Yperen, N. W., & Hagedoorn, M. (2003). Do high job demands increase intrinsic motivation or fatigue or both? The role of job control and job social support. Academy of Management Journal, 46, 339–348.
Varela, G., Varona, L., Anderson, K., & Sansoni, J. (2011). Alzheimer’s care at home: A focus on caregivers strain. Professioni Infermieristiche, 64(2), 113–117.
Vilagut, G., Forero, C. G., Barbaglia, G., & Alonso, J. (2016). Screening for depression in the general population with the Center for Epidemiologic Studies Depression (CES-D): A systematic review with meta-analysis. PLoS ONE, 11(5), e0155431. https://doi.org/10.1371/journal.pone.0155431
Virtanen, M., Stansfeld, S. A., Fuhrer, R., Ferrie, J. E., & Kivimäki, M. (2012). Overtime work as a predictor of major depressive episode: A 5-year follow-up of the Whitehall II study. PLoS ONE, 7(1), e30719. https://doi.org/10.1371/journal.pone.0030719
Yiengprugsawan, V., Leach, L., Berecki-Gisolf, J., Kendig, H., Harley, D., Seubsman, S. A., & Sleigh, A. C. (2016). Caregiving and mental health among workers: Longitudinal evidence from a large cohort of adults in Thailand. SSM – Population Health, 2, 149–154. https://doi.org/10.1016/j.ssmph.2016.01.004
Ying, J., Yap, P., Gandhi, M., & Liew, T. M. (2018). Iterating a framework for the prevention of caregiver depression in dementia: A multi-method approach. International Psychogeriatrics, 30(8), 1119–1130. https://doi.org/10.1017/S1041610217002629
Ying, J., Yap, P., Gandhi, M., & Liew, T. M. (2019). Validity and utility of the Center for Epidemiological Studies Depression Scale for detecting depression in family caregivers of persons with dementia. Dementia and Geriatric Cognitive Disorders, 15, 1–12.
Acknowledgements
The author would like to thank the participants for their contribution to the study, as well as Seiji Saito, Tetsuo Shimizu, Katsuyuki Murata, Yasutsugu Kudo, Tomokazu Asanuma, Masayuki Seki, and all the occupational physicians and their assistants from the Akita Occupational Health Promotion Centers for their help during the research.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics approval
This study was approved by the Research Ethics Board at the Japan Labor Health and Welfare Organization.
Consent to participate
All individual participants provided consent after they were informed that participation in the paper-based survey was voluntary and confidential.
Conflicts of interest
The author has no conflicts of interest to declare regarding the publication of this paper.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Fushimi, M. Factors associated with depressive symptoms among workers employed in Japanese eldercare institutions: a cross-sectional study based on the Job Demand–Control–Support Model. Curr Psychol 42, 28953–28960 (2023). https://doi.org/10.1007/s12144-022-03971-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-022-03971-6