BackgroundTaiwan’s National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals.MethodsWe posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution.ResultsThe survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males.ConclusionsThere was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.
This study investigated changes in job strain in female nurses serving in a military hospital system being restructured and the effect of these changes on psychological morbidity and quality of life (QOL). Questionnaire surveys were sent twice to 618 nurses working in three military hospitals in southern Taiwan at the beginning and at follow up a half year later. A Job Content Questionnaire was used to divide subjects into high and low strain groups. The General Health Questionnaire and the WHO QOL Questionnaire were used to assess psychological morbidity and QOL. Four hundred eighteen nurses completed the study. Initially, the high strain group had a greater prevalence of psychological morbidity and lower QOL than the low strain group. At follow up, high strain group did not have a greater prevalence of psychological morbidity, though significant differences in QOL remained. Job control and social support directly affected the QOL (B=0.42, p<0.001; B=0.41, p=0.038, respectively) and the psychological demand affected directly on psychological morbidity (B=0.12, p<0.001). Job control and psychological demand are different aspects in job strain to impact the psychological morbidity and QOL in nurses working in military hospitals in Taiwan.
These findings suggest that studies of the outcome of group psychotherapy must control for depressive symptoms. Quality of life may have been mediated by depression in this preliminary study.
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