Purpose – The purpose of this paper is to give a state‐of‐the art overview of the Job Demands‐Resources (JD‐R) modelDesign/methodology/approach – The strengths and weaknesses of the demand‐control model and the effort‐reward imbalance model regarding their predictive value for employee well being are discussed. The paper then introduces the more flexible JD‐R model and discusses its basic premises.Findings – The paper provides an overview of the studies that have been conducted with the JD‐R model. It discusses evidence for each of the model's main propositions. The JD‐R model can be used as a tool for human resource management. A two‐stage approach can highlight the strengths and weaknesses of individuals, work groups, departments, and organizations at large.Originality/value – This paper challenges existing stress models, and focuses on both negative and positive indicators of employee well being. In addition, it outlines how the JD‐R model can be applied to a wide range of occupations, and be used to i...

The job demands-resources model : state of the art

This study focuses on burnout and its positive antipode—engagement. A model is tested in which burnout and engagement have different predictors and different possible consequences. Structural equation modeling was used to simultaneously analyze data from four independent occupational samples (total N = 1698). Results confirm the hypothesized model indicating that: (1) burnout and engagement are negatively related, sharing between 10 per cent and 25 per cent of their variances; (2) burnout is mainly predicted by job demands but also by lack of job resources, whereas engagement is exclusively predicted by available job resources; (3) burnout is related to health problems as well as to turnover intention, whereas engagement is related only to the latter; (4) burnout mediates the relationship between job demands and health problems, whereas engagement mediates the relationship between job resources and turnover intention. The fact that burnout and engagement exhibit different patterns of possible causes and consequences implies that different intervention strategies should be used when burnout is to be reduced or engagement is to be enhanced. Copyright © 2004 John Wiley & Sons, Ltd.

/pdf/job-demands-job-resources-and-their-relationship-with-k0dg00q4k0.pdf

Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study

This article consists of three parts. Part 1 discusses the Job Content Questionnaire (JCQ), designed to measure scales assessing psychological demands, decision latitude, social support, physical demands, and job insecurity. Part 2 reports the cross-national validity, for men and women, of the JCQ scales in six broadly representative populations from four advanced industrial societies: the United States, Canada, the Netherlands and Japan. JCQ scale means, standard deviations, reliabilities and correlations are compared. Part 3 reviews comparison of the intercountry and interoccupation differences in the scales, discusses specific scales issues and discusses the implications of the study for interpretation of psychosocial job asessment questionnaires.

The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics.

The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years. The cohort will be selected from six US field centers. Approximately 38% of the cohort will be White, 28% African-American, 23% Hispanic, and 11% Asian (of Chinese descent). Baseline measurements will include measurement of coronary calcium using computed tomography; measurement of ventricular mass and function using cardiac magnetic resonance imaging; measurement of flow-mediated brachial artery endothelial vasodilation, carotid intimal-medial wall thickness, and distensibility of the carotid arteries using ultrasonography; measurement of peripheral vascular disease using ankle and brachial blood pressures; electrocardiography; and assessments of microalbuminuria, standard CVD risk factors, sociodemographic factors, life habits, and psychosocial factors. Blood samples will be assayed for putative biochemical risk factors and stored for use in nested case-control studies. DNA will be extracted and lymphocytes will be immortalized for genetic studies. Measurement of selected subclinical disease indicators and risk factors will be repeated for the study of progression over 7 years. Participants will be followed through 2008 for identification and characterization of CVD events, including acute myocardial infarction and other coronary heart disease, stroke, peripheral vascular disease, and congestive heart failure; therapeutic interventions for CVD; and mortality.

/pdf/multi-ethnic-study-of-atherosclerosis-objectives-and-design-2ly8fyhifg.pdf

Multi-Ethnic Study of Atherosclerosis: Objectives and Design

Recommendation 1: Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. The history should include assessment of psychosocial risk factors, which predict risk for chronic disabling back pain (strong recommendation, moderate-quality evidence). Recommendation 2: Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific low back pain (strong recommendation, moderate-quality evidence). Recommendation 3: Clinicians should perform diagnostic imaging and testing for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected on the basis of history and physical examination (strong recommendation, moderate-quality evidence). Recommendation 4: Clinicians should evaluate patients with persistent low back pain and signs or symptoms of radiculopathy or spinal stenosis with magnetic resonance imaging (preferred) or computed tomography only if they are potential candidates for surgery or epidural steroid injection (for suspected radiculopathy) (strong recommendation, moderate-quality evidence). Recommendation 5: Clinicians should provide patients with evidence-based information on low back pain with regard to their expected course, advise patients to remain active, and provide information about effective self-care options (strong recommendation, moderate-quality evidence). Recommendation 6: For patients with low back pain, clinicians should consider the use of medications with proven benefits in conjunction with back care information and self-care. Clinicians should assess severity of baseline pain and functional deficits, potential benefits, risks, and relative lack of long-term efficacy and safety data before initiating therapy (strong recommendation, moderate-quality evidence). For most patients, first-line medication options are acetaminophen or nonsteroidal anti-inflammatory drugs. Recommendation 7: For patients who do not improve with selfcare options, clinicians should consider the addition of nonpharmacologic therapy with proven benefits—for acute low back pain, spinal manipulation; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation (weak recommendation, moderate-quality evidence).

/pdf/diagnosis-and-treatment-of-low-back-pain-a-joint-clinical-wx8jag77hu.pdf

Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society

The objective of this review is to establish whether the epidemiologic literature presents evidence of an association between psychosocial work factors and musculoskeletal disease. In a hypothetical model it is suggested that individual characteristics and stress symptoms can modify this relationship. The reviewed studies do not present conclusive evidence due to high correlations between psychosocial factors and physical load and to difficulties in measuring dependent and independent variables. Nevertheless, it is concluded that monotonous work, high perceived work load, and time pressure are related to musculoskeletal symptoms. The data also suggest that low control on the job and lack of social support by colleagues are positively associated with musculoskeletal disease. Perceived stress may be an intermediary in this process. In addition, stress symptoms are often associated with musculoskeletal disease, and some studies indicate that stress symptoms contribute to the development of this disease.

Psychosocial factors at work and musculoskeletal disease

This study addressed the methodological quality of longitudinal research examining R. Karasek and T. Theorell's (1990) demand-control-(support) model and reviewed the results of the best of this research. Five criteria for evaluating methodological quality were used: type of design, length of time lags, quality of measures, method of analysis, and nonresponse analysis. These criteria were applied to 45 longitudinal studies, of which 19 (42%) obtained acceptable scores on all criteria. These high-quality studies provided only modest support for the hypothesis that especially the combination of high demands and low control results in high job strain. However, good evidence was found for lagged causal effects of work characteristics, especially for self-reported health or well-being outcomes.

The Very Best of the Millennium: Longitudinal Research and the Demand-Control-(Support) Model

Study Design. A systematic review of observational studies. Objectives. To assess whether psychosocial factors at work and in private life are risk factors for the occurrence of back pain. Summary of Background Data. Several reviews on risk factors for back pain have paid attention to psychosocial factors. However, in none of the published reviews was a strict systematic approach used to identify and summarize the available evidence Methods. A computerized bibliographical search of several databases was performed, restricted to studies with a cohort or case-control design. A rating system was used to assess the strength of the evidence for various factors, based on the methodologic quality of the studies and the consistency of the findings. Results. Eleven cohort and two case-control studies were included in this review. Strong evidence was found for low social support in the workplace and low job satisfaction as risk factors for back pain. Insufficient evidence was found for an effect of a high work pace, high qualitative demands, low job content, low job control, and psychosocial factors in private life. Conclusions. Evidence was found for an effect of low workplace social support and low job satisfaction. However, the result for workplace social support was sensitive to slight changes in the rating system, and the effect found for low job satisfaction may be a result of insufficient adjustment for psychosocial work characteristics and physical load at work. In addition, the combined evaluation of job content and job control, both aspects of decision latitude, led to strong evidence of a role for low job decision latitude. Thus, based on this review, there is evidence for an effect of work-related psychosocial factors, but the evidence for the role of specific factors has not been established yet.

/pdf/systematic-review-of-psychosocial-factors-at-work-and-8tgeerpm2z.pdf

Systematic review of psychosocial factors at work and private life as risk factors for back pain.

Background: In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focussed on upper limb problems. Methods: In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined. Results: The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High-perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency. Conclusions: High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies. © 2002 Wiley-Liss, Inc.

Paulien M. Bongers

Papers

The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics.

Psychosocial factors at work and musculoskeletal disease

The Very Best of the Millennium: Longitudinal Research and the Demand-Control-(Support) Model

Systematic review of psychosocial factors at work and private life as risk factors for back pain.

Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist?: A review of the epidemiological literature