Aspects of effort and reward in relation to WAI among nurses and call-center operators

Background: Conditions of Effort/Reward Imbalance (ERI) are known to impact negatively on work ability. Study aim is to elaborate on this relationship in two highly stressful occupations, i.e. nursing and the call-centre sector. Methods: A self-reported questionnaire including the ERI questionnaire and the Work Ability Index (WAI) was compiled by 1113 nurses employed in seven hospitals and 1106 call-centre operators (response rate=76,4% and 99.1% respectively). Among nurses, 86.5% were women, 45,5% were aged 31-40 years and mean job seniority was 12.6 (s.d. ±8.8); among call-centre operators, 77.4% were women, mean age was 33.4 years (s.d. 3.9) and mean job seniority 8.0 (s.d. 2.2). Results: Among nurses, 16.2% reported ERI (scores >1) and 33.4% had poor/moderate WAI. After adjustment for sex, age, marital status, number of children, workload, overcommitment and working time, ERI vs a “balanced condition” was more strongly associated with poor/moderate WAI (OR=2.4; C.I. 1.7-3.5). “Low reward” vs “high reward” and “high effort” vs “low effort” were more strongly associated with poor/moderate WAI (OR=2.7 C.I.=1.7-4.2 and OR=2.6 C.I.=1.6-4.2 respectively). Considering the “reward” subscales, only “low esteem reward” vs “high esteem” was significantly associated with poor/moderate WAI (OR=1.8 C.I. 1.1-2.9). Among call-center operators, 27.7% reported ERI and 19.8% a poor/moderate WAI. After adjustment for sex, age, marital status, number of children, education, job seniority, commuting time, overcommitment, job task (inbound/outbound), working time, ERI vs a “balanced condition” was more strongly associated with poor/moderate WAI (OR=2.1 C.I.=1.4-3.1). “Low reward” vs “high reward” was more strongly associated with poor/moderate WAI (OR=4.2 C.I.=2.4-7.2). Considering the “reward” subscales, only “low esteem reward” vs “high esteem” was significantly associated with poor/moderate WAI (OR=7.3 C.I.=2.9-18.9). Conclusions: Interventions to increase work ability may also address an adequate balance between workers’ efforts and rewards, with priority given to sustaining those aspects of reward in need of major improvement.