Working conditions, self-perceived stress, anxiety, depression and quality of life: a structural equation modelling approach

Bin Nordin Rusli, Bin Abdin Edimansyah, Lin Naing, Bin Nordin Rusli, Bin Abdin Edimansyah, Lin Naing

Abstract

Background: The relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia.

Methods: The validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation.

Results: The results of the SEM supported the hypothesized structural model (chi2 = 22.801, df = 19, p = 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF.

Conclusion: These findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers.

Figures

Figure 1
Figure 1
Significant pathways of the final model and goodness-of-fit indices. a e1–7 = error term 1–7. df = degree of freedom. GFI = Goodness-of-Fit Index. AGFI = Adjusted Goodness-of-Fit Index. CFI = Comparative Fit Index. Pratio = Parsimony Ratio. RMSEA = Root-Mean Square Error of Approximation.

References

    1. Karasek R, Theorell T. Healthy work: Stress, productivity, and the reconstruction of working life. New York , Basic Books; 1990.
    1. Karasek R, Baker D, Marxer F, Ahlbom A, Theorell T. Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. Am J Public Health. 1981;71:694–705.
    1. Cheng Y, Guo Y, Yeh W. A national survey of psychosocial job stressors and their implications for health among working people in Taiwan. Int Arch Occup Environ Health. 2001;74:495–504. doi: 10.1007/s004200100254.
    1. Bourbonnais R, Comeau M, Vezina M. Job strain and evolution of mental health among nurses. J Occup Health Psychol. 1999;4:95–107. doi: 10.1037/1076-8998.4.2.95.
    1. Karasek R. Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q. 1979;24:285–308. doi: 10.2307/2392498.
    1. Dollard MF, Winefield HR. A test of the Demand-Control/Support Model of work stress in Correctional Officers. J Occup Health Psychol. 1998;3:243.264.
    1. Karasek RA, Theorell T, Schwartz JE, Schnall PL, Pieper CF, Michela JL. Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES) Am J Public Health. 1988;78:910–918.
    1. Schwartz JE, Pieper CF, Karasek RA. A procedure for linking psychosocial job characteristics data to health surveys. Am J Public Health. 1988;78:904–909.
    1. Johnson JV, Hall EM. Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health. 1988;78:1336–1342.
    1. Jhun HJ, Cho SI, Park JT. Changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after the adoption of a computerized order communication system. Int Arch Occup Environ Health. 2004;77:363–367. doi: 10.1007/s00420-004-0509-2.
    1. Mohren DC, Swaen GM, Kant I, van Schayck CP, Galama JM. Fatigue and job stress as predictors for sickness absence during common infections. Int J Behav Med. 2005;12:11–20. doi: 10.1207/s15327558ijbm1201_2.
    1. Westman M, Eden D, Shirom A. Job stress, cigarette smoking and cessation: the conditioning effects of peer support. Soc Sci Med. 1985;20:637–644. doi: 10.1016/0277-9536(85)90402-2.
    1. Cheng Y, Kawachi I, Coakley EH, Schwartz J, Colditz G. Association between psychosocial work characteristics and health functioning in American women: prospective study. Bmj. 2000;320:1432–1436. doi: 10.1136/bmj.320.7247.1432.
    1. Lerner DJ, Levine S, Malspeis S, D'Agostino RB. Job strain and health-related quality of life in a national sample. Am J Public Health. 1994;84:1580–1585.
    1. Kudielka BM, Hanebuth D, von Kanel R, Gander ML, Grande G, Fischer JE. Health-related quality of life measured by the SF12 in working populations: associations with psychosocial work characteristics. J Occup Health Psychol. 2005;10:429–440. doi: 10.1037/1076-8998.10.4.429.
    1. Bennett P, Williams Y, Page N, Hood K, Woollard M. Levels of mental health problems among UK emergency ambulance workers. Emerg Med J. 2004;21:235–236. doi: 10.1136/emj.2003.005645.
    1. Newbury-Birch D, Kamali F. Psychological stress, anxiety, depression, job satisfaction, and personality characteristics in preregistration house officers. Postgrad Med J. 2001;77:109–111. doi: 10.1136/pmj.77.904.109.
    1. Caplan RP. Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers. Bmj. 1994;309:1261–1263.
    1. Plaisier I, de Bruijn JG, de Graaf R, Have MT, Beekman AT, Penninx BW. The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees. Soc Sci Med. 2006
    1. Sanne B, Mykletun A, Dahl AA, Moen BE, Tell GS. Testing the Job Demand-Control-Support model with anxiety and depression as outcomes: the Hordaland Health Study. Occup Med (Lond) 2005;55:463–473. doi: 10.1093/occmed/kqi071.
    1. Pikhart H, Bobak M, Pajak A, Malyutina S, Kubinova R, Topor R, Sebakova H, Nikitin Y, Marmot M. Psychosocial factors at work and depression in three countries of Central and Eastern Europe. Soc Sci Med. 2004;58:1475–1482. doi: 10.1016/S0277-9536(03)00350-2.
    1. Niedhammer I, Chastang JF, David S, Barouhiel L, Barrandon G. Psychosocial work environment and mental health: Job-strain and effort-reward imbalance models in a context of major organizational changes. Int J Occup Environ Health. 2006;12:111–119.
    1. Wang J, Patten SB. Perceived work stress and major depression in the Canadian employed population, 20-49 years old. J Occup Health Psychol. 2001;6:283–289. doi: 10.1037/1076-8998.6.4.283.
    1. Kawakami N, Iwata N, Tanigawa T, Oga H, Araki S, Fujihara S, Kitamura T. Prevalence of mood and anxiety disorders in a working population in Japan. J Occup Environ Med. 1996;38:899–905. doi: 10.1097/00043764-199609000-00012.
    1. Vanagas G, Bihari-Axelsson S, Vanagiene V. Do age, gender and marital status influence job strain development for general practitioner? Medicina (Kaunas) 2004;40:1014–1018.
    1. Chen HC, Chou FH, Chen MC, Su SF, Wang SY, Feng WW, Chen PC, Lai JY, Chao SS, Yang SL, Tsai TC, Tsai KY, Lin KS, Lee CY, Wu HC. A survey of quality of life and depression for police officers in Kaohsiung, Taiwan. Qual Life Res. 2006;15:925–932. doi: 10.1007/s11136-005-4829-9.
    1. Quilty LC, Van Ameringen M, Mancini C, Oakman J, Farvolden P. Quality of life and the anxiety disorders. J Anxiety Disord. 2003;17:405–426. doi: 10.1016/S0887-6185(02)00225-6.
    1. Diehr PH, Derleth AM, McKenna SP, Martin ML, Bushnell DM, Simon G, Patrick DL. Synchrony of change in depressive symptoms, health status, and quality of life in persons with clinical depression. Health Qual Life Outcomes. 2006;4:27. doi: 10.1186/1477-7525-4-27.
    1. Zatzick DF, Marmar CR, Weiss DS, Browner WS, Metzler TJ, Golding JM, Stewart A, Schlenger WE, Wells KB. Posttraumatic stress disorder and functioning and quality of life outcomes in a nationally representative sample of male Vietnam veterans. Am J Psychiatry. 1997;154:1690–1695.
    1. Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. Am J Psychiatry. 2000;157:669–682. doi: 10.1176/appi.ajp.157.5.669.
    1. Ravindran AV, Matheson K, Griffiths J, Merali Z, Anisman H. Stress, coping, uplifts, and quality of life in subtypes of depression: a conceptual frame and emerging data. J Affect Disord. 2002;71:121–130. doi: 10.1016/S0165-0327(01)00389-5.
    1. Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG. Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study. Occup Environ Med. 1999;56:302–307.
    1. WHOQOL Group The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41:1403–1409. doi: 10.1016/0277-9536(95)00112-K.
    1. Nasermoaddeli A, Sekine M, Hamanishi S, Kagamimori S. Associations between sense of coherence and psychological work characteristics with changes in quality of life in Japanese civil servants: a 1-year follow-up study. Ind Health. 2003;41:236–241.
    1. Stansfeld SA, Bosma H, Hemingway H, Marmot MG. Psychosocial work characteristics and social support as predictors of SF-36 health functioning: the Whitehall II study. Psychosom Med. 1998;60:247–255.
    1. Ay-Woan P, Sarah CP, Lyinn C, Tsyr-Jang C, Ping-Chuan H. Quality of life in depression: predictive models. Qual Life Res. 2006;15:39–48. doi: 10.1007/s11136-005-0381-x.
    1. Liang HW, Kuo HW, Lin CF, Shy HY, Chen HW, Chen JJ. Factor construct of health-related quality of life in Taiwanese workers by WHOQOL-BREF questionnaire. Mid Taiwan J Med. 2005;10:113–122.
    1. Edimansyah BA, Rusli BN, Naing L, Mazalisah BM. Reliability and construct validity of the Malay version of the Job Content Questionnaire (JCQ) Southeast Asian J Trop Med Public Health. 2006;37:412–416.
    1. Karasek R. Job Content Questionnaire and User's Guide. Los Angeles , University of Southern California, Department of Industrial Engineering and Operation Research; 1985.
    1. Edimansyah BA, Rusli BN, Naing L, Mazlan BA, Rampal KG, Shamsul Bahri BMT, Nik Khairol Reza BMY, Ahmad Syaarani BY, Azwan BA, Mazalisah BM, Kamarudin BH. Reliability and concurrent validity of the Malay version of Depression Anxiety Stress Scale (DASS) in automotive assembly workers in Malaysia. Malaysian Journal of Public Health Medicine. 2005;5
    1. Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2. Sydney , School of Psychology, University of New South Wales; 2002.
    1. Hasanah CI, Naing L, Rahman AR. World Health Organization Quality of Life Assessment: brief version in Bahasa Malaysia. Med J Malaysia. 2003;58:79–88.
    1. SPSS Inc. SPSS version 12.0.1 for Windows. Chicago , SPSS Inc.; 2003.
    1. SPSS Inc. AMOS TM Software. Chicago , SPSS Inc.; 2005.
    1. Arbuckle JL. Amos™ 6.0 User’s Guide. Chicago , SPSS Inc.; 2005.
    1. JÖreskog KG, SÖrdom D. LISREL VIII: Analysis of linear structural relations. Mooresville, IN , Scientific Software; 1992.
    1. Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107:238–246. doi: 10.1037/0033-2909.107.2.238.
    1. Steiger JH. Structural model evaluation and modification: An interval estimation approach. Multivariate Behav Res. 1990;25:173–180. doi: 10.1207/s15327906mbr2502_4.
    1. Mulaik SA, L. R. James. J. Van Alstine. N. Bennett. S. Lind. Stilwell. CD. Evaluation of goodness-of-fit indices for structural equation models. Psychol Bull. 1989;105.:430–445. doi: 10.1037/0033-2909.105.3.430.
    1. Knox SS, Theorell T, Svensson JC, Waller D. The relation of social support and working environment to medical variables associated with elevated blood pressure in young males: a structural equation model. Soc Sci Med. 1985;21:525–531. doi: 10.1016/0277-9536(85)90036-X.
    1. Niedhammer I, Goldberg M, Leclerc A, Bugel I, David S. Psychosocial work environment and cardiovascular risk factors in an occupational cohort in France. J Epidemiol Community Health. 1998;52:93–100.
    1. Kawakami N, Tsutsumi A, Haratani T, Kobayashi F, Ishizaki M, Hayashi T, Fujita O, Aizawa Y, Miyazaki S, Hiro H, Masumoto T, Hashimoto S, Araki S. Job strain, worksite support, and nutrient intake among employed Japanese men and women. J Epidemiol. 2006;16:79–89. doi: 10.2188/jea.16.79.
    1. Ezoe S, Araki S, Ono Y, Kawakami N, Murata K. In: Psychiatric symptoms, work stress and personality traits in Japanese computer workers: A comparative study of the effects of age, school career and computer work: Tokyo. Araki S, editor. Elsevier; 1992. pp. 181–188.
    1. Amick BC, Kawachi I, Coakley EH, Lerner D, Levine S, Colditz GA. Relationship of job strain and iso-strain to health status in a cohort of women in the United States. Scand J Work Environ Health. 1998;24:54–61.
    1. Wallgren LG, Hanse JJ. Job characteristics, motivators and stress among information technology consultants: A structural equation modeling approach. Int J Ind Ergo. 2007;37:51–59. doi: 10.1016/j.ergon.2006.10.005.
    1. Vanagas G, Bihari-Axelsson S. Cross-sectional study on quality of life, work demands and psychosocial stress of Lithuanian general practitioners. Eur J Gen Pract. 2004;10:169–170.
    1. Flaherty JA, FM. G, Black EM, Altman E, Mitchell T. The role of social support in the functioning of patients with unipolar depression. Am J Psychiatry. 1983;140:473–476.
    1. Brugha TS, Bebbington PE, MacCarthy B, Sturt E, Wykes T, Potter J. Gender, social support and recovery from depressive disorders: a prospective clinical study. Psychol Med. 1990;20:147–156.
    1. Zlotnick C, Shea MT, Pilkonis PA, Elkin I, Ryan C. Gender, type of treatment, dysfunctional attitudes, social support, life events, and depressive symptoms over naturalistic follow-up. Am J Psychiatry. 1996;153:1021–1027.
    1. Kojima M, Senda Y, Nagaya T, Tokudome S, Furukawa TA. Alexithymia, depression and social support among japanese workers. Psychotheraphy and Psychosomatics. 2003;72:307–314. doi: 10.1159/000073027.
    1. Friedman LC, Brown AE, Romero C, Dulay MF, Peterson LE, Wehrman P, Whisnand DJ, Laufman L, Lomax J. Depressed mood and social support as predictors of quality of life in women receiving home health care. Qual Life Res. 2005;14:1925–1929. doi: 10.1007/s11136-005-4326-1.
    1. Greenglass ER, Burke RJ, Moore KA. Reactions to increased workload: Effects on professional efficacy of nurses. Appl Psychol: An Inter Rev. 2003;52:580–597. doi: 10.1111/1464-0597.00152.
    1. Heaney CA, Israel BA, House JS. Chronic job insecurity among automobile workers: effects on job satisfaction and health. Soc Sci Med. 1994;38: 1431–1437. doi: 10.1016/0277-9536(94)90281-X.
    1. Plaisier I, de Bruijn JG, de Graaf R, Have MT, Beekman AT, Penninx BW. The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees. Soc Sci Med. 2007; 64:401–410. doi: 10.1016/j.socscimed.2006.09.008.
    1. Rugulies R, Bultmann U, Aust B, Burr H. Psychosocial work environment and incidence of severe depressive symptoms: prospective findings from a 5-year follow-up of the Danish work environment cohort study. Am J Epidemiol. 2006;163:877–887. doi: 10.1093/aje/kwj119.
    1. Stansfeld S, Fuhrer R, Shipley MJ, Marmot M. Work characteristics predict psychiatric disorder: Prospective results from the Whitehall II Study. Occup Environ Med. 1999;56:302–307.
    1. Niedhammer I, Goldberg M, Leclerc A, Bugel I, David S. Psychosocial factors at work and subsequent depressive symptoms in the Gazel cohort. Scand J Work Environ Health. 1998;24:197–205.
    1. Ferrie JE, Shipley MJ, Stansfeld SA, Marmot MG. Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study. J Epidemiol Community Health. 2002;56:450–454. doi: 10.1136/jech.56.6.450.
    1. Mausner-Dorsch H, Eaton WW. Psychosocial work environment and depression: epidemiologic assessment of the demand-control model. Am J Public Health. 2000;90:1765–1770.
    1. Jenkins GD, Nadler DA, Lawler EE, Cammann C. Standized observation: an approach to measuring the nature of jobs. J Appl Psychol. 1975 ;60 :171–181. doi: 10.1037/h0076541.
    1. Kristensen TS. The demand-control-support model: methodological challenges for future research. Stress Med. 1996 ;11:17–26. doi: 10.1002/smi.2460110104.
    1. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998;3:322–355. doi: 10.1037/1076-8998.3.4.322.
    1. Muhonen T, Torkelson E. The Demand-Control-Support model and health among women and men in similar occupations. J Behav Med. 2003;26:601–613. doi: 10.1023/A:1026257903871.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться