Effort-reward imbalance and work ability index among italian female nurses : the role of family status and work-family conflict

Background: While many studies concentrated on the role of gender and biological/chronological age as moderators in the relationship between Work Ability Index and Effort/Reward Imbalance, our aim is to evaluate, in a representative sample of female Italian nurses, the cross-sectional association between work-related stress and work ability, considering the role of family status and work-family conflict. Methods: A total of 3949 female nurses (aged 21-64) were included in the analyses (3623 from the Italian NEXT-study and 326 from six representative healthcare institutions of the Lazio Region, Italy). Work-related stress was measured with the Effort-Reward Imbalance Questionnaire (ERI-Q; Siegrist et al., 2004). Work ability was assessed with the Work Ability Index (WAI) and Work-Family Conflict by means of the five-item scale by Netemeyer et al. (1996). Relationships between the variables of interest were analyzed by means of General Linear Models (GLM). Results: About one-third (27.2%) reported low work ability (WAI<37) and 30.1% an ERI score higher than 1, indicating work-related stress. Lower WAI levels related to ageing were clear for WAI sub-items 3, 4 and 6, while the sub-item 5 was lower among adults living alone with child/ren. GLM results (adjusting for age, shift work, family status, number of children under 7 yrs and additional off-work caring responsibilities) showed that lower levels of work ability were associated with higher effort-reward imbalance (B=-4.49; 95% CI=-6.36, -2.62) and work-family conflict (B=-1.32; 95% CI=-1.80, -0.86). Discussion and Conclusion: Our results confirm that among Italian nurses work-related stress is associated with lower work ability. Work-family conflict shares variance with Effort-Reward Imbalance only partially, which means that not necessarily efforts spent at work limits the conciliation between home- and work-related activities. To maintain and promote work ability, healthcare organizations should also consider, beyond work-related stress, problems female nurses may face in combining work and home duties.