The Evolution of Effort-Reward Imbalance in Workers during the COVID-19 Pandemic in France-An Observational Study in More than 8000 Workers

Louis Delamarre, Salma Tannous, Ines Lakbar, Sébastien Couarraze, Bruno Pereira, Marc Leone, Fouad Marhar, Julien S Baker, Reza Bagheri, Mickael Berton, Hana Rabbouch, Marek Zak, Tomasz Sikorski, Magdalena Wasik, Hijrah Nasir, Binh Quach, Jiao Jiao, Raimundo Aviles, Covistress Network, Maëlys Clinchamps, Fréderic Dutheil, Louis Delamarre, Salma Tannous, Ines Lakbar, Sébastien Couarraze, Bruno Pereira, Marc Leone, Fouad Marhar, Julien S Baker, Reza Bagheri, Mickael Berton, Hana Rabbouch, Marek Zak, Tomasz Sikorski, Magdalena Wasik, Hijrah Nasir, Binh Quach, Jiao Jiao, Raimundo Aviles, Covistress Network, Maëlys Clinchamps, Fréderic Dutheil

Abstract

(1) Background: The effects of lockdown repetition on work-related stress, expressed through Effort-Reward Imbalance (ERI), during the COVID-19 pandemic are poorly documented. We investigated the effect of repetitive lockdowns on the ERI in French workers, its difference across occupations, and the change in its influencing factors across time. (2) Methods: Participants were included in a prospective cross-sectional observational study from 30 March 2020 to 28 May 2021. The primary outcome was the ERI score (visual analog scale). The ERI score of the population was examined via Generalized Estimating Equations. For each period, the factors influencing ERI were studied by multivariate linear regression. (3) Results: In 8121 participants, the ERI score decreased in the first 2 lockdowns (53.2 ± 0.3, p < 0.001; 50.5 ± 0.7, p < 0.001) and after lockdown 2 (54.8 ± 0.8, p = 0.004) compared with the pre-pandemic period (59 ± 0.4). ERI was higher in medical than in paramedical professionals in the pre-pandemic and the first 2 lockdowns. Higher workloads were associated with better ERI scores. (4) Conclusions: In a large French sample, Effort-Reward Imbalance worsened during the COVID-19 pandemic until the end of the 2nd lockdown. Paramedical professionals experienced a higher burden of stress compared with medical professionals.

Trial registration: ClinicalTrials.gov NCT04538586.

Keywords: France; Sars-CoV-2; Siegrist’s framework; lockdowns; work-related stress.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of participants. Abbreviations: *: participants aged 75 were excluded from the analysis.
Figure 2
Figure 2
Effort-Reward Imbalance (ERI) score across the periods of interest. Abbreviations: **:

Figure 3

Effort-Reward Imbalance (ERI) score across…

Figure 3

Effort-Reward Imbalance (ERI) score across the periods of interest according to occupations. Plot…

Figure 3
Effort-Reward Imbalance (ERI) score across the periods of interest according to occupations. Plot (A): in medical professionals, Plot (B): in paramedical professionals, Plot (C): in other workers. Abbreviations: *: <0.05; **: <0.01; ****: <0.0001.

Figure 4

Summary of GEE model with…

Figure 4

Summary of GEE model with exchangeable covariance structure (GEE-ex).

Figure 4
Summary of GEE model with exchangeable covariance structure (GEE-ex).
Figure 3
Figure 3
Effort-Reward Imbalance (ERI) score across the periods of interest according to occupations. Plot (A): in medical professionals, Plot (B): in paramedical professionals, Plot (C): in other workers. Abbreviations: *: <0.05; **: <0.01; ****: <0.0001.
Figure 4
Figure 4
Summary of GEE model with exchangeable covariance structure (GEE-ex).

References

    1. Garbóczy S., Szemán-Nagy A., Ahmad M.S., Harsányi S., Ocsenás D., Rekenyi V., Al-Tammemi A.B., Kolozsvári L.R. Health Anxiety, Perceived Stress, and Coping Styles in the Shadow of the COVID-19. BMC Psychol. 2021;9:53. doi: 10.1186/s40359-021-00560-3.
    1. Sandoval-Reyes J., Idrovo-Carlier S., Duque-Oliva E.J. Remote Work, Work Stress, and Work–Life during Pandemic Times: A Latin America Situation. Int. J. Environ. Res. Public Health. 2021;18:7069. doi: 10.3390/ijerph18137069.
    1. Galanti T., Guidetti G., Mazzei E., Zappalà S., Toscano F. Work from Home during the COVID-19 Outbreak: The Impact on Employees’ Remote Work Productivity, Engagement and Stress. J. Occup. Environ. Med. 2021 doi: 10.1097/JOM.0000000000002236. publish ahead of print .
    1. Murat M., Köse S., Savaşer S. Determination of Stress, Depression and Burnout Levels of Front-line Nurses during the COVID-19 Pandemic. Int. J. Ment. Health Nurs. 2021;30:533–543. doi: 10.1111/inm.12818.
    1. Labrague L.J., Santos J.A.A. Fear of COVID-19, Psychological Distress, Work Satisfaction and Turnover Intention among Frontline Nurses. J. Nurs. Manag. 2021;29:395–403. doi: 10.1111/jonm.13168.
    1. Minahan J., Falzarano F., Yazdani N., Siedlecki K.L. The COVID-19 Pandemic and Psychosocial Outcomes Across Age Through the Stress and Coping Framework. Gerontologist. 2021;61:228–239. doi: 10.1093/geront/gnaa205.
    1. Manzano García G., Ayala Calvo J.C. The Threat of COVID-19 and Its Influence on Nursing Staff Burnout. J. Adv. Nurs. 2021;77:832–844. doi: 10.1111/jan.14642.
    1. Charles N.E., Strong S.J., Burns L.C., Bullerjahn M.R., Serafine K.M. Increased Mood Disorder Symptoms, Perceived Stress, and Alcohol Use among College Students during the COVID-19 Pandemic. Psychiatry Res. 2021;296:113706. doi: 10.1016/j.psychres.2021.113706.
    1. Ceri V., Cicek I. Psychological Well-Being, Depression and Stress During COVID-19 Pandemic in Turkey: A Comparative Study of Healthcare Professionals and Non-Healthcare Professionals. Psychol. Health Med. 2021;26:85–97. doi: 10.1080/13548506.2020.1859566.
    1. Apouey B., Roulet A., Solal I., Stabile M. Gig Workers during the COVID-19 Crisis in France: Financial Precarity and Mental Well-Being. J. Urban Health. 2020;97:776–795. doi: 10.1007/s11524-020-00480-4.
    1. Trumello C., Bramanti S.M., Ballarotto G., Candelori C., Cerniglia L., Cimino S., Crudele M., Lombardi L., Pignataro S., Viceconti M.L., et al. Psychological Adjustment of Healthcare Workers in Italy during the COVID-19 Pandemic: Differences in Stress, Anxiety, Depression, Burnout, Secondary Trauma, and Compassion Satisfaction between Frontline and Non-Frontline Professionals. Int. J. Environ. Res. Public Health. 2020;17:8358. doi: 10.3390/ijerph17228358.
    1. Kuo F., Yang P., Hsu H., Su C., Chen C., Yeh I., Wu Y., Chen L. Survey on Perceived Work Stress and Its Influencing Factors among Hospital Staff during the COVID-19 Pandemic in Taiwan. Kaohsiung J. Med. Sci. 2020;36:944–952. doi: 10.1002/kjm2.12294.
    1. Wardell J.D., Kempe T., Rapinda K.K., Single A., Bilevicius E., Frohlich J.R., Hendershot C.S., Keough M.T. Drinking to Cope During COVID-19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking, and Alcohol Problems. Alcohol. Clin. Exp. Res. 2020;44:2073–2083. doi: 10.1111/acer.14425.
    1. Raudenská J., Steinerová V., Javůrková A., Urits I., Kaye A.D., Viswanath O., Varrassi G. Occupational Burnout Syndrome and Post-Traumatic Stress among Healthcare Professionals during the Novel Coronavirus Disease 2019 (COVID-19) Pandemic. Best Pract. Res. Clin. Anaesthesiol. 2020;34:553–560. doi: 10.1016/j.bpa.2020.07.008.
    1. Moretti A., Menna F., Aulicino M., Paoletta M., Liguori S., Iolascon G. Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis. Int. J. Environ. Res. Public Health. 2020;17:6284. doi: 10.3390/ijerph17176284.
    1. Restauri N., Sheridan A.D. Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions. J. Am. Coll. Radiol. 2020;17:921–926. doi: 10.1016/j.jacr.2020.05.021.
    1. Kluge H.H.P. Statement—Physical and Mental Health Key to Resilience during COVID-19 Pandemic. [(accessed on 14 July 2022)]. Available online: .
    1. World Health Organization . Mental Health and Psychosocial Considerations during the COVID-19 Outbreak. WHO; Geneva, Switzerland: 2020. pp. 1–6.
    1. National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health Coping with Stress Coping with Stress. CDC Mental Health. [(accessed on 14 July 2022)];2022 Available online: .
    1. Siegrist J. Adverse Health Effects of High-Effort/Low-Reward Conditions. J. Occup. Health Psychol. 1996;1:27–41. doi: 10.1037/1076-8998.1.1.27.
    1. Violanti J.M., Mnatsakanova A., Andrew M.E., Allison P., Gu J.K., Fekedulegn D. Effort-Reward Imbalance and Overcommitment at Work: Associations with Police Burnout. Police Q. 2018;21:440–460. doi: 10.1177/1098611118774764.
    1. de Jonge J., Bosma H., Peter R., Siegrist J. Job Strain, Effort-Reward Imbalance and Employee Well-Being: A Large-Scale Cross-Sectional Study. Soc. Sci. Med. 2000;50:1317–1327. doi: 10.1016/S0277-9536(99)00388-3.
    1. Godin I., Kittel F., Coppieters Y., Siegrist J. A Prospective Study of Cumulative Job Stress in Relation to Mental Health. BMC Public Health. 2005;5:67. doi: 10.1186/1471-2458-5-67.
    1. Kivimäki M., Leino-Arjas P., Luukkonen R., Riihimäki H., Vahtera J., Kirjonen J. Work Stress and Risk of Cardiovascular Mortality: Prospective Cohort Study of Industrial Employees. BMJ. 2002;325:5. doi: 10.1136/bmj.325.7369.857.
    1. van Vegchel N., de Jonge J., Bosma H., Schaufeli W. Reviewing the Effort–Reward Imbalance Model: Drawing up the Balance of 45 Empirical Studies. Soc. Sci. Med. 2005;60:1117–1131. doi: 10.1016/j.socscimed.2004.06.043.
    1. Dey A., Majumdar P., Saha A., Sahu S. COVID-19 Pandemic Lockdown-Induced Altered Sleep/Wake Circadian Rhythm, Health Complaints and Stress among Traffic Police Personnel in India. Chronobiol. Int. 2021;38:140–148. doi: 10.1080/07420528.2020.1831524.
    1. Couarraze S., Delamarre L., Marhar F., Quach B., Jiao J., Avilés Dorlhiac R., Saadaoui F., Liu A.S.-I., Dubuis B., Antunes S., et al. The Major Worldwide Stress of Healthcare Professionals during the First Wave of the COVID-19 Pandemic—the International COVISTRESS Survey. PLoS ONE. 2021;16:e0257840. doi: 10.1371/journal.pone.0257840.
    1. Ruiz-Fernández M.D., Ramos-Pichardo J.D., Ibáñez-Masero O., Cabrera-Troya J., Carmona-Rega M.I., Ortega-Galán Á.M. Compassion Fatigue, Burnout, Compassion Satisfaction and Perceived Stress in Healthcare Professionals during the COVID-19 Health Crisis in Spain. J. Creat. Behav. 2020;29:4321–4330. doi: 10.1111/jocn.15469.
    1. Liu Y., Wang H., Chen J., Zhang X., Yue X., Ke J., Wang B., Peng C. Emergency Management of Nursing Human Resources and Supplies to Respond to Coronavirus Disease 2019 Epidemic. Int. J. Nurs. Sci. 2020;7:135–138. doi: 10.1016/j.ijnss.2020.03.011.
    1. Humphries N., Morgan K., Catherine Conry M., McGowan Y., Montgomery A., McGee H. Quality of Care and Health Professional Burnout: Narrative Literature Review. Int. J. Health Care Qual. Assur. 2014;27:293–307. doi: 10.1108/IJHCQA-08-2012-0087.
    1. Gilbert-Ouimet M., Brisson C., Vézina M. Psychosocial Work Stressors, High Family Responsibilities, and Psychological Distress among Women: A 5-year Prospective Study. Am. J. Ind. Med. 2020;63:170–179. doi: 10.1002/ajim.23070.
    1. Sperlich S., Geyer S. The Impact of Social and Family-Related Factors on Women’s Stress Experience in Household and Family Work. Int. J. Public Health. 2015;60:375–387. doi: 10.1007/s00038-015-0654-2.
    1. Dutheil F., Pereira B., Moustafa F., Naughton G., Lesage F.-X., Lambert C. At-Risk and Intervention Thresholds of Occupational Stress Using a Visual Analogue Scale. PLoS ONE. 2017;12:e0178948. doi: 10.1371/journal.pone.0178948.
    1. Ballinger G.A. Using Generalized Estimating Equations for Longitudinal Data Analysis. Organ. Res. Methods. 2004;7:127–150. doi: 10.1177/1094428104263672.
    1. Zeger S.L., Liang K.-Y. Longitudinal Data Analysis for Discrete and Continuous Outcomes. Biometrics. 1986;42:121. doi: 10.2307/2531248.
    1. Liang K.-Y., Zeger S.L. Longitudinal Data Analysis Using Generalized Linear Models. Biometrika. 1986;73:13–22. doi: 10.1093/biomet/73.1.13.
    1. Pan W. Akaike’s Information Criterion in Generalized Estimating Equations. Biometrics. 2001;57:120–125. doi: 10.1111/j.0006-341X.2001.00120.x.
    1. INSEE . Tableaux de L’économie Française. Edition 2017. INSEE (Institut national de la statistique et des études économiques); Paris, France: 2017. Insee Références.
    1. INSEE . Activité, Emploi et Chômage en 2019 et en Séries Longues. Enquête Emploi en Continu. INSEE (Institut national de la statistique et des études économiques); Paris, France: 2020. Insee Résultats.
    1. R Core Team . R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; Vienna, Austria: 2021.
    1. von Elm E., Altman D.G., Egger M., Pocock S.J., Gøtzsche P.C., Vandenbroucke J.P., STROBE Initiative Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. BMJ. 2007;335:806–808. doi: 10.1136/.
    1. Shechter A., Diaz F., Moise N., Anstey D.E., Ye S., Agarwal S., Birk J.L., Brodie D., Cannone D.E., Chang B., et al. Psychological Distress, Coping Behaviors, and Preferences for Support among New York Healthcare Workers during the COVID-19 Pandemic. Gen. Hosp. Psychiatry. 2020;66:1–8. doi: 10.1016/j.genhosppsych.2020.06.007.
    1. Ross J. The Exacerbation of Burnout During COVID-19: A Major Concern for Nurse Safety. J. Perianesthesia Nurs. 2020;35:439–440. doi: 10.1016/j.jopan.2020.04.001.
    1. Elbay R.Y., Kurtulmuş A., Arpacıoğlu S., Karadere E. Depression, Anxiety, Stress Levels of Physicians and Associated Factors in Covid-19 Pandemics. Psychiatry Res. 2020;290:113130. doi: 10.1016/j.psychres.2020.113130.
    1. Bouziri H., Smith D.R.M., Descatha A., Dab W., Jean K. Working from Home in the Time of COVID-19: How to Best Preserve Occupational Health? Occup. Environ. Med. 2020;77:509–510. doi: 10.1136/oemed-2020-106599.
    1. Godeluck S. Pénuries de Personnel: Les Hôpitaux ne Parviennent pas à se Relever Après Dix-Huit Mois de Covid. Les Echos. Oct 28, 2021. [(accessed on 1 February 2022)]. Available online: .
    1. Sauvage G. Pénurie de Soignants: Le Modèle Hospitalier Français au Bord de la Rupture. France24. Oct 29, 2021. [(accessed on 1 February 2022)]. Available online: .
    1. Parmentier A. “Une Explosion de Burn-Out”: Après le Covid, les Hôpitaux face à une Pénurie de Soignants. L’Express. Oct 12, 2021. [(accessed on 1 February 2022)]. Available online: .
    1. Décret n° 2020-325 du 25 Mars 2020 Relatif à L’activité Partielle. 2020. [(accessed on 1 June 2022)]. Available online: .

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa