Associations between effort–reward imbalance and health indicators among school teachers in Chuquisaca, Bolivia: a cross-sectional study

Abstract

ObjectiveTo assess the association between effort–reward imbalance (ERI) and health indicators among Bolivian school teachers.DesignSchool-based cross-sectional study.SettingSixty randomly selected schools from rural (33) and urban (27) schools in Chuquisaca, Bolivia.ParticipantsA total of 1062 school teachers were invited to participate, of which 597 answered the questionnaire (response 56.2%).Exposure measurePsychosocial factors at work were explored through the short version of the Effort–Reward Questionnaire.Primary and secondary outcome measuresHealth outcomes included self-rated overall health, mental distress (12-item General Health Questionnaire ≥5) and the 7-day prevalence of low back pain (LBP) as well as neck or shoulder pain (Nordic Questionnaire). Crude and adjusted ORs and their 95% CIs for each health outcome were calculated using logistic regression models.ResultsThe median value for the effort–reward ratio was 0.91 (range: 0.3–2.3) with higher values for teachers from rural versus urban schools. Overall, about 43% of the teachers reported their overall health as fair or poor; 45% suffered mental distress, 17% reported LBP and 29% neck or shoulder pain. Prevalences were higher for teachers employed at rural schools compared with those at urban schools. After adjusting for potential confounders and school location, ERI was statistically significantly associated with fair/poor self-rated health (adjusted OR 1.7, 95% CI 1.0 to 2.9); mental distress (1.9; 95% CI 1.2 to 3.1) and LBP (2.3; 95% CI 1.3 to 4.1).ConclusionOur results indicate the urgent need to improve psychosocial working conditions among Bolivian school teachers, in order to promote their health and well-being.

Evaluation of the correlation between effort-reward imbalance and sleep quality among community health workers

“…Health workers with poor sleep quality had higher levels of perceived effort, higher levels of perceived overcommitment, and higher ERI ratios than those with good sleep quality (Table 3 ). This finding is consistent with existing study findings [ 49 ]. Table 4 shows that the ERI ratio is the main risk factor for sleep disturbances in community health workers, and the same result was found for doctors and nurses.…”

Evaluation of the Correlation Between Effort-reward Imbalance and Sleep Quality Among Community Health Workers

“…The results of this study showed that health workers with poor sleep quality had higher levels of perceived effort, higher levels of perceived overcommitment, and higher ERI ratios than those with good sleep quality (Table 3). This is consistent with existing research [43] . Table 4 shows that the ERI ratio was the main risk factor for sleep disturbances in community health workers (P = 0.000, OR = 34.334).…”

Gender-Specific Aspects of Teachers Regarding Working Behavior and Early Retirement

“…In a favorable case, for example, teachers’ high workload is compensated by adequate pay and appreciation by colleagues and students. According to this model, an effort-reward imbalance (ERI) generates psychosocial work stress that increases the risk of stress-associated illness and burnout in the medium and long term ( Van Vegchel et al, 2005 , Lehr et al, 2009 ; Zurlo et al, 2010 ; Wang et al, 2015 ; Rugulies et al, 2017 ; Solis-Soto et al, 2019 ; Madsen and Rugulies, 2021 ). In the study by Loerbroks et al (2014) , the ERI score in elementary school teachers was found to be a strong determinant not only of burnout but also of intention to leave the profession.…”