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Aim and background  This study examines the influence of changes in work conditions on stress outcomes as well as influence of changes in stress outcomes on work conditions. As such, it answers questions still open in the literature regarding causality of work environmental characteristics and the health of nurses. Method  A complete, two wave panel design was used with a time interval of 3 years. The sample consisted of 381 hospital nurses in different functions, working in different wards. Results  Changes in work conditions are predictive of the outcomes, especially of job satisfaction and emotional exhaustion. The strongest predictors of job satisfaction were social support from supervisor, reward and control over work. The strongest predictors of emotional exhaustion were work and time pressure and physical demands. Reversed relationships were also found for these outcomes. Conclusion  The results of this study are consistent with transactional models of stress that indicate that stressors and stress outcomes mutually influence each other. To prevent nurses from a negative spiral, it seems of importance to intervene early in the process.

Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions.

This study examines whether worry is prospectively associated with somatic complaints and whether a worry reduction intervention can decrease these complaints. One hundred and seventy-one high school students (16-17 years old) kept a log of their worry duration and frequency for 6 days, of whom half were instructed to try to postpone worrying to a special 30-min worry period each day ('postponers'). Somatic symptoms during 'the last 3 days' were assessed before and after the 6 days. At follow-up, postponers reported fewer complaints than controls, controlled for baseline. This reduction appeared to be mediated by worry duration, and pertained to, amongst others, lower back pain, neck pain, coughing/bronchitis, breathing difficulties and stomach pains. Thus, daily worry appears to be prospectively related to a broad set of somatic complaints, and its effect might be reversed by a simple intervention. Possible underlying mechanisms include prolonged physiological activity and illnessrelated perseverative cognition.

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Aims.  To describe job conditions, job satisfaction, somatic complaints and burnout of female East African nurses working in public and private hospitals and to determine how these well‐being outcomes are associated with job conditions. Background.  Insight into job conditions, health and well‐being status and their interrelation is virtually lacking for East African nurses. Design.  Cross‐sectional survey of 309 female nurses in private and public hospitals in Kenya, Tanzania and Uganda. Methods.  Nurses completed a survey assessing job conditions and job satisfaction (the Leiden Quality of Work Life Questionnaire – nurses version), somatic complaints (subscale of the Symptom CheckList) and burnout (Maslach Burnout Inventory). Results.  The East African nurses show high levels of somatic complaints, and nearly one‐third of the sample would be labelled as burned out. In comparison with a Western European nurses reference group, the nurses score unfavourably on job conditions that require financial investment (e.g. workload, staffing, equipment and materials). On aspects related to the social climate (e.g. decision latitude, cooperation), however, they score more favourably. In comparison with private hospital nurses, public hospital nurses score similarly on aspects related to the social climate, but worse on the other job conditions. Public hospital nurses have a lower job satisfaction than private hospital nurses, but show comparable levels of somatic complaints and burnout. Strongest correlates of low job satisfaction are low supervisor support and low financial reward. Burnout is mainly associated with high workload and inadequate information provision, whereas somatic complaints are associated with demanding physical working conditions. Conclusions.  Improvement in job conditions may reduce the high levels of burnout and somatic complaints and enhance job satisfaction in East African nurses. Relevance to clinical practice.  Efforts and investments should be made to improve the job conditions in East African nurses as they are key persons in the delivery of health care.

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Based on two leading models in occupational stress research, the Job Demand-Control-Support model and the Michigan model, a comprehensive quality of work questionnaire, was constructed--the Leiden Quality of Work Questionnaire. The factor structure of this questionnaire was assessed and cross-validated in two sub-samples of 2,000 men and women from a large sample of the Dutch working population. Analysis indicated that the questionnaire measures 11 work characteristics of Skill Discretion, Decision Authority, Task Control, Work and Time Pressure, Role Ambiguity, Physical Exertion, Hazardous Exposure, Job Insecurity, Lack of Meaningfulness, Social Support from Supervisor and Social Support from Coworkers, and the outcome variable of Job Satisfaction in a reliable way.