Job Demands, Job Resources, Burnout, Work

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Job Demands, Job Resources, Burnout, Work Engagement, and Their Relationships: An Analysis Across Sectors Anja Van den Broeck, PhD, Tinne Vander Elst, PhD, Elfi Baillien, PhD, Maarten Sercu, MSc, Martijn Schouteden, PhD, Hans De Witte, PhD, and Lode Godderis, PhD

Objective: The aim of this study was to gain insight in the importance of job demands and resources and the validity of the Job Demands Resources Model across sectors. Methods: We used one-way analyses of variance to examine mean differences, and multi-group Structural Equation Modeling analyses to test the strength of the relationships among job demands, resources, burnout, and work engagement across the health care, industry, service, and public sector. Results: The four sectors differed in the experience of job demands, resources, burnout, and work engagement, but they did not vary in how (strongly) job demands and resources associated with burnout and work engagement. Conclusion: More attention is needed to decrease burnout and increase work engagement, particularly in industry, service, and the public sector. The Job Demands-Resources model may be helpful in this regard, as it is valid across sectors.

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ork stress is one of the most common work-related health problems in Europe (http://osha.europa.eu/en/publications/ factsheets/22/view). However, although work can be a burden, workers are generally in better health than those who do not work.1,2 Work may thus have both detrimental and beneficial consequences for employee mental health. The Job Demands-Resources model (JD-R model) captures this duality in terms of job demands and resources (as characteristics of work) and in terms of burnout and work engagement (as indicators of employee well-being).3 The JDR model has been investigated in multiple settings, mainly in organization-specific samples. However, it is less clear to what extent sectors may differ with respect to the presence of and associations between job demands, job resources, burnout, and work engagement. To address these questions, the current study explores whether four sectors (ie, the health care, industry, service, and public sector) are characterized by different levels of job demands, job resources, burnout, and work engagement. In addition, we investigate whether job demands and resources are related to burnout and work engagement across sectors to the same extent, thereby offering evidence on the generalizability of the JD-R model across sectors.

From the Research Center of Work and Organizational Studies, Faculty of Economics and Business, KU Leuven, Belgium (Drs Van den Broeck, Baillien); Optentia Research Focus Area, Vanderbijlpark Campus, North West University, Vanderbijlpark, South Africa (Drs Van den Broeck, De Witte); Knowledge, Information and Research Center, IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium (Dr Vander Elst, Mr Sercu, Drs Schouteden, Godderis); Research Group Work, Organizational and Personnel Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium (Drs De Witte, Vander Elst); and Centre Environment and Health, Department of Public Health and Primary Care, KU Leuven, Belgium (Dr Godderis). Authors Van den Broeck, Elst, Baillien, Sercu, Schouteden, De Witte, and Godderis have no relationships/conditions/circumstances that present potential conflict of interest. The JOEM editorial board and planners have no financial interest related to this research. Address correspondence to: Anja Van den Broeck, PhD, Warmoesberg 26, 1000 Brussel, Belgium ([email protected]). Copyright ß 2017 American College of Occupational and Environmental Medicine DOI: 10.1097/JOM.0000000000000964

JOEM Volume 59, Number 4, April 2017

Learning Objectives Summarize the evidence base on the relationship of job demands and job resources to burnout and work engagement. Identify the new findings on how these associations may vary across different work sectors. Discuss the implications for efforts to decrease burnout and increase work engagement in specific sectors.

BURNOUT AND WORK ENGAGEMENT Burnout is defined as a syndrome of emotional exhaustion and depersonalization/cynicism.4 It was first diagnosed in the 1970s among service workers who suffered from mental fatigue and (therefore) depersonalized their clients to distance themselves from the high emotional demands in their work. In the 1990s, burnout was also recognized among other occupations (eg, clerical workers and computer specialists) who were equally fatigued, became cynical, and detached themselves from work.4 Work engagement, in contrast, is a positive, motivational work-related state of mind that is characterized by vigor, dedication, and absorption.5 Engaged workers feel highly energized, are enthusiast about their work, and can be happily engrossed into their work, feeling that time passes by quickly. Burnout and work engagement are complementary and both matter for employee mental and physical health, also outside work.3 Some scholars have tapped into the prevalence of burnout, suggesting that about 17% of the population is characterized by high levels of burnout.6 Other studies targeting specific occupations, for example, showed that burnout prevails among 11.3% of the residential anaesthesiologists,7 37.9% of the emergency nurses,8 and up to 56% of the medical students and residents.9 Regarding work engagement, global consultancy firms suggest that 25% and 15% of the American and European workers, respectively, are highly engaged.10 Jenaro et al,11 for instance, reported a prevalence of 13.3% highly engaged workers in a sample of Spanish nurses. These studies, however, provide little details on the measurement or cut-off values used to assess burnout and work engagement, or only provide insight in particular professions, largely limited to the health care sector. They leave the occurrence of burnout and work engagement across sectors unknown. However, from a practical perspective, sectorspecific information on burnout and work engagement may be valuable: Policy may target efforts and resources to improve employee mental health to the sectors most in need, while managers may want to screen one’s own organization vis-a-vis comparable organizations in the sector. Therefore, this study explores how multiple sectors differ with respect to the level of burnout and work engagement.

JOB DEMANDS AND JOB RESOURCES PREDICTING BURNOUT AND WORK ENGAGEMENT According to the JD-R model,3,12,13 burnout and work engagement are determined by the presence of job characteristics, which can 369

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Van den Broeck et al

be grouped into the broad categories of job demands and job resources. Job demands, such as workload and role conflict, are those physical, psychological, social, or organizational aspects of work that require sustained physical and/or psychological effort or skills and are energy-depleting. Therefore, they are the key risk factors for the development of burnout.14,15 Job resources, for instance, social support and autonomy, are the physical, psychological, social, or organizational aspects of the job that are (1) functional in achieving work goals, (2) reduce job demands and the associated physiological and psychological costs, and (3) stimulate personal growth, learning, and development. They are intrinsically and/or extrinsically motivating and therefore considered as the primary drivers of work engagement, although they may also offset burnout.14,15 The relationships of job demands and job resources with burnout and work engagement have received quite some support. Hansez and Chmiel,16 for example, showed that employees from the energy sector reported higher levels of burnout when being confronted with job demands such as work overload and role ambiguity, while they were more engaged when they experienced job resources such as decision latitude and social support. Using a heterogeneous sample of organizations in industry, health care, and the public sector, Brauchli et al17 found that changes in job demands (eg, work interruptions, time pressure, uncertainty, and overload) and changes in job resources (eg, social support, job control, task significance, and interpersonal justice) related to changes in burnout and work engagement over time, lending support to the causality of these relationships. Although these exemplary studies support that job demands and job resources are important, they are conducted either among heterogeneous samples or among relatively small homogeneous samples consisting of employees of a single organization. Therefore, they may neglect possible differences across sectors.18,19 Consequently, despite that we seem to know a lot about job demands, job resources, burnout, and work engagement, we have a poor understanding of the occurrence of job demands and job resources across sectors and whether they relate to burnout and work engagement in a similar way across sectors. Some authors suggest that such differences may occur. For example, Stone and Deadrick20 suggest that blue-collar workers in industry may have less job resources than service employees. Bakker and Sanz-Vergel21 propose that for health care, emotional demands may be less cumbersome, as they would expect such demands and see them as an inherent part of their job, while this would not be so much the case in industry. Despite these suggestions, to date, no research systematically examined sector differences in the presence and/or relations of job demands, job resources, burnout, and engagement. The JD-R model remains silent on whether such differences may occur or not, and does not provide any theoretical assumptions that allow to formulate a priory hypotheses.3,12 Therefore, the main aims of the present study are (1) to explore whether employees may differ across sectors in terms of the level of job demands, job resources, burnout, and work engagement, and (2) to test whether job demands and resources are related to burnout and work engagement to the same extent across sectors. We focus on the health care, industry, service, and public sector, thereby tapping into an important part of the labor market, and examine the most often studied job demands and job resources. Particularly, we include workload and role conflict, which are among the core job demands,22 and equally focus on cognitive demands to account for the increasing demands for information processing that typifies today’s working contexts.23,24 With respect to job resources, we study social support, employee autonomy, and skill utilization, which have been considered essential work aspects.25,26 370

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TABLE 1. Description of the Sample

N Age, years Mean SD Gender Women Men Occupational level Blue-collar workers White-collar workers Managerial position Education Lower educated Bachelor or master degree

Health Care

Industry

Service Sector

Public Sector

571

399

864

751

42.92 10.97

42.89 8.89

39.55 10.04

43.97 10.99

81.4% 18.6%

18.5% 81.5%

52.4% 47.6%

46.1% 53.9%

5.5% 89.7% 4.9%

43.8% 41.3% 14.9%

3.8% 79.6% 16.5%

9.9% 80.1% 10%

28.5% 71.5%

49.9% 50.1%

26.0% 74.0%

54.9% 43.1%

METHODS Study Population Data were collected among a panel in 2012 and 2013 through an anonymous online questionnaire. Panel members were recruited via a mix of channels, including visual and print media, and off-line and on-line recruitment. Employees were asked in which sector they were working: (1) (human) health care (eg, physicians in hospitals, home health care nurses); (2) industry referring to all kinds of manufacturing and utilities (eg, chemical industry, textile, production, and distribution of electricity); (3) the service sector covering (eg, IT, financial services, consultancy, but not, eg, repair and installation of machinery or equipment, wholesale and retail trade, or accommodation and food service activities); (4) the public sector including public administration and general public services; or other sectors. Stratified sampling and statistical weighting were used to arrive at representative samples of the population of Belgian employees these four sectors in view of gender (male – female) and age (younger than 45 years to 45 years or older). The total sample consisted of 2585 employees (health care: n ¼ 571; industry: n ¼ 399; service sector: n ¼ 864; public sector: n ¼ 751). Tables 1 and 2 give an overview of the sample and population characteristics for each sector.

Measurements Job Demands and Job Resources Both workload and cognitive demands were assessed using three items (eg, ‘‘I work under time pressure’’ and ‘‘Does your work require your continuous attention,’’ respectively).26 Role conflict was based on three items such as ‘‘I get conflicting orders.’’27 Social support from colleagues was measured using two items (eg, ‘‘If necessary, I can ask my colleagues for help’’).28 Autonomy and skill utilization were each assessed with four items such as ‘‘I can plan my own work’’ and ‘‘My work requires me to learn new things,’’ respectively.26 Responses on the scales of job demands and job resources were coded on a five-point Likert scale ranging from 1 ‘‘(almost) never’’ to 5 ‘‘(almost) always.’’

Burnout and Work Engagement Burnout was measured using the Dutch version of the Maslach Burnout Inventory General Survey (MBI-GS)29 including five items of exhaustion, such as ‘‘I feel totally exhausted in my job,’’ and four items of cynicism ‘‘I feel cynical about my job.’’ Responses were coded on a seven-point scale from 1 (‘‘never’’) to 7 (‘‘always, every day’’). 2017 American College of Occupational and Environmental Medicine

Copyright © 2017 American College of Occupational and Environmental Medicine. Unauthorized reproduction of this article is prohibited


Demands, Resources, Burnout, and Work Engagement Across Sectors

TABLE 2. Characteristics of the Population and Sample of Belgian Employees for Health Care, Industry, the Service Sector, and the Public Sector Population of Belgian Employees Sector Health care

Gender

Age, years

Absolute Number

Male