Abstract
Purpose
The aim of this study was providing descriptive information and the comparative examination of job strain and mental health of nurses and physicians in different intensive care units (ICU).
Methods
The Effort–Reward Imbalance Questionnaire by Siegrist and standardized psychometric questionnaires, like Hospital Anxiety and Depression Scale, Impact of Event Scale, Brief Symptom Inventory, Social Support Questionnaire, and Life Satisfaction Questionnaire were used. Five ICUs of the same German medical school were included (N = 142).
Results
For all ICUs investigated, a significantly lower mental health and a high effort–reward imbalance were found when compared with other samples. Only a few differences between the wards or both professional groups (nurses vs. physicians) were noted. The values for social support were comparable with those of healthy controls but differed between the wards. The life satisfaction in our cohort was lower compared to a population-based sample but was significant different between the wards.
Conclusions
Our study demonstrates the high job strain in an ICU, largely independent of the professional group. Noteworthy, a high effort–reward imbalance was found that stands in positive relation to adverse health effects (anxiety, depression, and general mental health). As a consequence, necessary interventions like stress management, supervision, and communication trainings should consider ward-specific conditions of employment rather than professional affiliation. After these interventions, a follow-up study will be performed to examine beneficial effects on job strain and health.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Angerer P, Petru R, Nowak D, Weigl M (2008) Working conditions and depression in physicians. Dtsch Med Wochenschr 133:26–29
Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77
Bonn D, Bonn J (2000) Work-related stress: can it be a thing of the past? Lancet 355(9198):124
Bourbonnais R, Brisson C, Vézina M (2010) Long-term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting. Occup Environ Med. doi:10.1136/oem.2010.055202
Buddeberg-Fischer B, Klaghofer R, Stamm M, Siegrist J, Buddeberg C (2008) Work stress and reduced health in young physicians: prospective evidence from Swiss residents. Int Arch Occup Environ Health 82(1):31–38
Dragano N, He Y, Moebus S, Jockel KH, Erbel R, Siegrist J (2008) Two models of job stress and depressive symptoms. Results from a population-based study. Soc Psych Psych Epid 43(1):72–78
Edward KL, Hercelinskyj G (2007) Burnout in the caring nurse: learning resilient behaviours. Brit J Nurs 16(4):240–242
Fahrenberg J, Myrtek M, Schumacher J, Brähler E (2000) Life Satisfaction Questionnaire (LSQ). Hogrefe, Göttingen
Franke GH (2000) Brief symptom inventory by L.R. Degrogatis (BSI- German version). Beltz Verlag, Göttingen
Fydrich T, Geyer M, Hessel A, Sommer G, Brähler E (1999) Questionnaire for social support (F-SozU): standardization of a representative sample of the German population. Diagnostica 45:212–216
Fydrich T, Sommer G, Brähler E (2007) Questionnaire for Social Support (F-SozU): manual. Hogrefe, Göttingen
Guntupalli KK, Fromm RE Jr (1996) Burnout in the internist-intensivist. Intens Care Med 22(7):625–630
Herrmann C, Buss U (1994) Presentation and validation of a German version of the Hospital Anxiety and Depression Scale (HAD-Scale). Diagnostica 40:143–154
Herrmann C, Buss U, Snaith RP (2005) HADS-D: Hospital Anxiety and Depression Scale—German version. Verlag Hans Huber, Hogrefe, Bern
Jenkins R, Elliott P (2004) Stressors, burnout and social support: nurses in acute mental health settings. J Adv Nurs 48(6):622–631
Joksimovic L, Starke D, von dem Knesebeck O, Siegrist J (2002) Perceived work stress, overcommitment, and self-reported musculoskeletal pain: a cross-sectional investigation. Int J Behav Med 9(2):122–138
Kelly JG, Cross DG (1985) Stress, coping behaviors, and recommendations for intensive care and medical surgical ward registered nurses. Res Nurs Health 8(4):321–328
Kinzl JF, Traweger C, Biebl W, Lederer W (2006) Burnout and stress disorders in intensive care doctors. Deut Med Wochenschr 131(44):2461–2464
Lederer W, Kinzl JF, Trefalt E, Traweger C, Benzer A (2006) Significance of working conditions on burnout in anesthetists. Acta Anaesth Scand 50(1):58–63
Lederer W, Kinzl JF, Traweger C, Dosch J, Sumann G (2008) Fully developed burnout and burnout risk in intensive care personnel at a university hospital. Anaesth Intensi Care 36(2):208–213
Lehr D, Koch S, Hillert A (2010) Where is (im) balance? Necessity and construction of evaluated cut-off points for effort–reward imbalance and overcommitment. J Occup Organ Psych 83(1):251–261
Li J, Galatsch M, Siegrist J, Muller BH, Hasselhorn HM (2010) Reward frustration at work and intention to leave the nursing profession-Prospective results from the European longitudinal NEXT study. Int J Nurs Stud. doi:10.1016/j.ijnurstu.2010.09.011
Maercker A, Schützwohl M (1998) Erfassung von psychischen Belastungsfolgen: die impact of event Skala—revidierte version (IES-R). Diagnostica 44:130–141
Murji A, Gomez M, Knighton J, Fish JS (2006) Emotional implications of working in a burn unit. J Burn Care Res 27(1):8–13
Niedhammer I, Tek ML, Starke D, Siegrist J (2004) Effort–reward imbalance model and self-reported health: cross-sectional and prospective findings from the GAZEL cohort. Soc Sci Med 58(8):1531–1541
North FM, Syme SL, Feeney A, Shipley M, Marmot M (1996) Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health 86(3):332–340
Redinbaugh EM, Sullivan AM, Block SD, Gadmer NM, Lakoma M, Mitchell AM, Seltzer D, Wolford J, Arnold RM (2003) Doctors’ emotional reactions to recent death of a patient: cross sectional study of hospital doctors. BMJ 327(7408):185
Reinhard F, Maercker A (2004) Secondary traumatization, posttraumatic stress disorder, burnout and social support in emergency care personnel. Z Med Psychol 13:29–36
Rödel A, Siegrist J, Hessel A, Brähler E (2004) Psychometric test of the questionnaire measuring effort–reward imbalance at work in a representative German sample. Z für Differentielle und Diagnostische Psychologie 25(4):227–238
Schumacher J, Laubach W, Brähler E (1995) How satisfied with our lives are we? Z Med Psychol 4:17–26
Shanafelt TD, Bradley KA, Wipf JE, Back AL (2002) Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 136(5):258–367
Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, Collicott P, Novotny PJ, Sloan J, Freischlag J (2010) Burnout and medical errors among American surgeons. Ann Surg 251(6):995–1000
Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1(1):27–41
Siegrist J (2005) Social reciprocity and health: new scientific evidence and policy implications. Psychoneuroendocrinology 30(10):1033–1038
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(8):1483–1499
Sommer G, Fydrich T (1991) Development and testing of a questionnaire of social support. Diagnostica 37:160–178
Stansfeld S, Candy B (2006) Psychosocial work environment and mental health- a meta-analytic review. Scand J Work Environ Health 32(6):443–462
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(5):302–307
Steenkamp WC, van der Merwe AE (1998) The psychosocial functioning of nurses in a burn unit. Burns 24(3):253–258
van Vegchel N, de Jonge J, Bosma H, Schaufeli W (2005) Reviewing the effort–reward imbalance model: drawing up the balance of 45 empirical studies. Soc Sci Med 60(5):1117–1131
von dem Knesebeck O, Klein J, Grosse Frie K, Blum K, Siegrist J (2010) Psychosocial stress among hospital doctors in surgical fields: results of a nationwide survey in Germany. Dtsch Arztebl Int 107(14):248–253
Wallace JE, Lemaire JB, Ghali WA (2009) Physician wellness: a missing quality indicator. Lancet 374(9702):1714–1721
Weyers S, Peter R, Boggild H, Jeppesen HJ, Siegrist J (2006) Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort–reward imbalance model. Scand J Caring Sci 20(1):26–34
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psych Scand 67:361–370
Acknowledgments
We thank all contributors and participants of the survey who took the time to answer the questionnaires. Furthermore, we are grateful to all chairmen and nursing staff members in leading positions of the involved departments, the chair of the personnel management department, and the president of Hannover Medical School for approving the study.
Conflicts of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jasper, S., Stephan, M., Al-Khalaf, H. et al. Too little appreciation for great expenditure? Workload and resources in ICUs. Int Arch Occup Environ Health 85, 753–761 (2012). https://doi.org/10.1007/s00420-011-0721-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-011-0721-9