Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University, Lueneburg, Germany.
Division of Psychology & Digital Mental Health Care, Department for Sport & Health Sciences, Technical University of Munich, Munich, Germany.
J Med Internet Res. 2022 Oct 20;24(10):e40488. doi: 10.2196/40488.
Work stress is highly prevalent and puts employees at risk for adverse health consequences. Web-based stress management interventions (SMIs) promoting occupational self-efficacy might be a feasible approach to aid employees to alleviate this burden and to enable them to improve an unbalanced situation between efforts and rewards at work.
The first aim of this randomized controlled trial was to investigate the efficacy of a web-based SMI for employees perceiving elevated stress levels and an effort-reward imbalance in comparison to a waitlist control (WLC) group. Second, we investigated whether the efficacy of an SMI could be explained by an increase in occupational self-efficacy and whether this personal resource enables employees to change adverse working conditions.
A total of 262 employees reporting effort-reward imbalance scores over 0.715 and elevated stress levels (10-item Perceived Stress Scale [PSS-10] score ≥22) were randomly assigned to either the intervention group (IG; SMI) or the WLC group. The primary outcome was perceived stress measured using the PSS-10. The secondary outcomes included mental and work-related health measures. Four different mediation analyses were conducted with occupational self-efficacy, efforts, and rewards as mediators. After eligibility screening, data were collected web based at baseline (T1), 7 weeks (T2) and 6 months (T3).
Study participation was completed by 80% (105/130, 80.8%) in the IG and 90% (119/132, 90.2%) in the WLC group. Analyses of covariance revealed that stress reduction was significantly higher for the SMI group compared with the WLC group at T2 (d=0.87, 95% CI 0.61-1.12, P<.001) and T3 (d=0.65, 95% CI 0.41-0.90, P<.001). Mediation analyses indicated that occupational self-efficacy mediated the beneficial effect of the SMI on stress directly. Furthermore, the analyses revealed a significant indirect effect of occupational self-efficacy via rewards (b=0.18, t=4.52, P<.001), but not via efforts (b=0.01, t=0.27, P>.05) while efforts still had a negative impact on stress (b=0.46, t=2.32, P<.05).
The SMI was effective in reducing stress and improving occupational self-efficacy in employees despite them experiencing an effort-reward imbalance at work. Results from mediation analyses suggest that fostering personal resources such as occupational self-efficacy contributes to the efficacy of the SMI and enables employees to achieve positive changes regarding the rewarding aspects of the workplace. However, the SMI seemed to neither directly nor indirectly impact efforts, suggesting that person-focused interventions might not be sufficient and need to be complemented by organizational-focused interventions to comprehensively improve mental health in employees facing adverse working conditions.
German Clinical Trials Register DRKS00005990; https://tinyurl.com/23fmzfu3.
工作压力普遍存在，使员工面临不良健康后果的风险。促进职业自我效能感的基于网络的压力管理干预（SMI）可能是一种帮助员工减轻这种负担的可行方法，并使他们能够改善工作中努力与回报之间的不平衡状况。
这项随机对照试验的首要目的是比较基于网络的 SMI 对感知压力水平升高和努力-回报失衡的员工与等待名单对照组（WLC）的疗效。其次，我们研究了 SMI 的疗效是否可以通过职业自我效能感的提高来解释，以及这种个人资源是否使员工能够改变不利的工作条件。
共有 262 名报告努力-回报失衡得分超过 0.715 和压力水平升高（10 项感知压力量表[PSS-10]得分≥22）的员工被随机分配到干预组（IG；SMI）或等待名单对照组（WLC）。主要结局是使用 PSS-10 测量感知压力。次要结局包括心理健康和与工作相关的健康测量。进行了四项不同的中介分析，以职业自我效能感、努力和回报作为中介。在资格筛选后，在基线（T1）、7 周（T2）和 6 个月（T3）进行基于网络的数据收集。
IG 组中有 80%（105/130，80.8%）和 WLC 组中有 90%（119/132，90.2%）完成了研究参与。协方差分析显示，与 WLC 组相比，SMI 组在 T2（d=0.87，95%CI 0.61-1.12，P<.001）和 T3（d=0.65，95%CI 0.41-0.90，P<.001）时压力降低更为显著。中介分析表明，职业自我效能感直接介导了 SMI 的有益效果。此外，分析还显示，职业自我效能感通过奖励（b=0.18，t=4.52，P<.001）对压力产生显著的间接影响，但通过努力（b=0.01，t=0.27，P>.05）则没有，而努力仍然对压力产生负面影响（b=0.46，t=2.32，P<.05）。
尽管员工在工作中经历了努力-回报失衡，但 SMI 仍能有效降低压力和提高职业自我效能感。中介分析的结果表明，培养职业自我效能感等个人资源有助于 SMI 的疗效，并使员工能够在工作场所的奖励方面取得积极的变化。然而，SMI 似乎既没有直接也没有间接影响努力，这表明以个人为中心的干预措施可能不够，需要补充以组织为中心的干预措施，以全面改善面临不利工作条件的员工的心理健康。
德国临床试验注册处 DRKS00005990；https://tinyurl.com/23fmzfu3。
