The effect of effort-reward imbalance on the health of childcare workers in Hamburg: a longitudinal study

Abstract

BackgroundThe prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis.MethodsIn 2014 childcare workers (N = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later (N = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression.ResultsAt baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points (p = 0.034).ConclusionsERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI.Electronic supplementary materialThe online version of this article (doi:10.1186/s12995-017-0163-8) contains supplementary material, which is available to authorized users.

Factors associated with preschool workers’ willingness to continue working

“…[1] Many preschool workers also report having health problems, particularly musculoskeletal complaints. [3–5] Further, regarding the mental health aspects of preschool workers, low satisfaction in work is common among this population. [2,6] Thus, preschool work is a profession that induces a high mental and physical burden.…”

“…[8,9] Social support is also a job factor, and supervisor support and organizational support have been determined to contribute to reductions in turnover intention; [10] conversely, social exclusion at work has been found to increase turnover intention. [11] Effort-reward imbalance (ERI) in work is also considered to be related to higher turnover intention, mainly due to its association with burnout; [5,12] for example, in a cross-sectional study of 436 elementary school teachers in China, logistic regression analysis revealed that ERI is an independent risk factor for burnout. [12]…”

Effort‐reward imbalance and ambulatory blood pressure among female Las Vegas hotel room cleaners

“…Combined with the myriad other health effects of work stress such as musculoskeletal injury, clinical depression, decreased leisure time physical activity, to name a few, our findings suggest that comprehensive workplace interventions in this particular population may be warranted that reduce both work stressors and physical workloads. To address the many different adverse health effects of work stress, companies and any worksite wellness or occupational safety and health programs should in general consider multi‐pronged, evidence‐based worksite interventions similar to Total Worker Health initiatives proposed by the National Institute for Occupational Safety and Health (NIOSH) that include policies to increase worker control and flexibility on how to perform their work tasks, strategies for supervisors to reduce stressful working conditions, specific cardiovascular health promotion efforts, and skill‐building interventions for stress management in the workplace .…”

Vulnerability to infectious and contagious diseases in daycare center teachers: an observational study

“…ERI was revealed to be an important factor in relation to MS and burnout in childcare workers. 18 In Denmark the average number of students per teacher is 2.82 and it was found that absenteeism in that group of teachers was directly related to the number of students. 19 The more students per teacher the higher the annual absenteeism index.…”