Next Article in Journal
The Summer 2019–2020 Wildfires in East Coast Australia and Their Impacts on Air Quality and Health in New South Wales, Australia
Next Article in Special Issue
Employee Voice: A Mechanism to Harness Employees’ Potential for Sustainable Success
Previous Article in Journal
Assessing Hotel Employee Knowledge on Risk Factors and Risk Management Procedures for Microbial Contamination of Hotel Water Distribution Systems
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
IJERPH
Volume 18
Issue 7
10.3390/ijerph18073540
ijerph-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Effect of Work–Family Conflict, Psychological Job Demand, and Job Control on the Health Status of Nurses

by
Li-Chung Pien
1,2,
Wan-Ju Cheng
3,4,
Kuei-Ru Chou
5,6,7,8 and
Li-Chiu Lin
9,*
1
Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan
2
Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan District 116, Taipei 11608, Taiwan
3
Department of Psychiatry, China Medical University Hospital, No. 2, Yude Rd., North District 404332, Taichung 40447, Taiwan
4
Department of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun District 406040, Taichung 40402, Taiwan
5
School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan
6
Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan District 116, Taipei 11608, Taiwan
7
Department of Nursing, Taipei Medical University-Shuang Ho Hospital, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City 23561, Taiwan
8
Psychiatric Research Center, Taipei Medical University Hospital, No. 252, Wuxing Street, Xinyi District, Taipei 110301, Taiwan
9
Nursing Department, Hung Kuang University, 1018 Taiwan Boulevard, Sec. 6, Shalu District, Taichung 433304, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(7), 3540; https://doi.org/10.3390/ijerph18073540
Submission received: 17 February 2021 / Revised: 26 March 2021 / Accepted: 27 March 2021 / Published: 29 March 2021
(This article belongs to the Special Issue Psychological Safety in the Workplace)
Review Reports Versions Notes

Abstract

:
Work–family conflicts (WFCs) are common in the healthcare sector and pose significant health risks to healthcare workers. This study examined the effect of WFCs on the health status and nurses’ leaving intentions in Taiwan. A self-administered questionnaire was used to survey 200 female nurses’ experiences of WFC from a regional hospital. Data on psychosocial work conditions, including work shifts, job control, psychological job demands, and workplace justice, were collected. Health conditions were measured using the Beck Depression Inventory-II and self-rated health. Leaving intentions were measured using a self-developed questionnaire. The participants’ average work experience was 6.79 (Standard Deviation (SD) = 5.26) years, their highest educational level was university, and work shifts were mostly night and rotating shifts. Approximately 75.5% of nurses perceived high levels of WFCs. Leaving intentions were correlated with WFCs (r = 0.350, p < 0.01) and psychological work demands (r = 0.377, p < 0.01). After adjusting for age, educational level, and work characteristics, high levels of WFCs were associated with poor self-rated health, and depression, but not associated with high leaving intentions. Nurses’ experiences of high levels of WFCs greatly affected their health status.

1. Introduction

Statistics of the Taiwan Union of Nurses Association (TUNA), Taiwan and Fujian Province of China, in September 2020 showed that Taiwan had 180,526 licensed and 170,240 nursing workers, of which 96.5% were women [1]. Currently, the nursing work force in Taiwan consists mostly of women. The nursing manpower shortage in Taiwan causes a relatively uneven nurse-to-patient ratio, high work pressure, and high work load, which result in increased overtime and turnover rates. Female workers have to fulfil family household responsibilities in addition to bearing workplace pressure, resulting in conflicts between family and work [1,2]. Especially, work–family conflicts (WFCs) are a common problem faced by nursing staff [3,4].
However, WFCs are not only an issue in Taiwan but also around the world; different types of literature have indicated [3,4,5,6,7,8] that working conditions are much more about WFCs. As employed women, nurses have to not only cope with workplace pressure but also take care of housework and children after completing work. Furthermore, research has shown that role conflicts between work and housework are the biggest sources of stress for women [9,10]. Therefore, work–family conflicts (WFCs) and occupational fatigue of female nursing staff are essential indicators and tools for their assessment. If medical institution managers understand the WFCs of married female nursing staff and improve their work conditions and environment, they can reduce the pressure, promote nurses’ physical and mental health, and improve the quality and effectiveness of care services.

2. Literature Review

Different types of literature show that WFC is an essential factor affecting workers’ physical and mental health [5,7,11]. Kahn et al. (1964) defined WFC as ‘’the conflict and pressure between roles caused by the incompatibility between work and family roles’’ [12]. Furthermore, a systematic review indicated out by Greenhaus and Buetell [13] in 1985 maintained that WFC undoubtedly reflects people’s belief that work and family life are interdependent. Hu et al. [6] also indicated that different norms and responsibilities are involved in work and family, and that the work role may make fulfilling family roles difficult, which leads to WFCs.
Moreover, some studies also stated that conflict and pressure result from competition between multiple roles [6,13]. For instance, in 2019, Galletta et al. [7] examined the moderating role of collective affective commitment as a protective resource in the relationship between WFC and emotional exhaustion in 2019. The study [7] found that emotional commitment can be regarded as a protective resource for nurses. Nurses with low family and work conflict have a higher investment in work. The researchers [7] recommend using interventions to reduce WFC, promote nurse’s commitment, and reduce emotional exhaustion. Conflict and pressure lead to decreased time and energy, making it difficult for workers to perform their roles, resulting in excessive workload and fatigue [5,6].
After investigating 351 full-time participants, the Zhou et al. [14] study suggested that WFC affected the level of self-reported mental health. Those researchers [14] indicated that conflict between workplace and family is not only a negative impact but also a predictor of mental health. Evidence also shows that WFCs are markedly related to worker health and work performance [5]. High levels of WFCs can cause physical and mental stress and emotional exhaustion [14,15,16]. In terms of physical health, poor self-rated health (SRH) [8,11]; depression [17,18,19,20]; problem drinking behavior [15,18]; and physical symptoms such as fatigue, lack of appetite, and nervous tension are positively correlated [15,21,22].
Some investigators have found that a favorable workplace enables workers to balance their work and family roles, thereby reducing WFCs [8,14,23,24,25]. However, studies also indicated that workplace characteristics such as low job control, high psychological work demands, night/rotating shifts, and low workplace justice are risk factors for the poor physical and mental health of workers [26,27,28]. Especially, with increased working hours, high pressure, and shift work, the nursing profession is associated with a high risk of WFCs [11,23,29]. In particular, compared with male nurses, female nurses face a high level of WFC [19]. In terms of work, WFCs can lead to poor quality of care provided by nursing staff [30] and increased turnover rates [30,31,32,33]. In 2013, Pien et al. [11] surveyed 17,892 participants to investigate the impact of WFC on mental health. The researchers found that heavy workload, low workplace justice, and family care burden were associated with WFC and subsequently with poor mental health [11].
In previous studies on WFCs, simultaneous consideration of the effects of work characteristics on the health of nursing staff is lacking. It is unclear whether the health effects of WFCs still remain significant after controlling for psychosocial work conditions. This research aimed to determine the effects of WFCs and major psychosocial work characteristics relevant to nurses on their health. We hypothesized that WFCs was associated with worse health among nurses after adjustment for psychosocial work conditions.

3. Methods

3.1. Study Population and Procedures

This cross-sectional study was conducted using standardized self-administered questionnaires. Convenience sampling of female nurses was performed. A total of 220 questionnaires were distributed, and 200 copies were retrieved and used for the final analysis the response rate was 90.9%. The inclusion criteria were female nurses with a full-time job, age ≥20 years, and employed by a hospital at the time of the survey. A trained research assistant of our research team administered research questionnaires to nurses.

3.2. Measurements

3.2.1. WFC Assessment

The Chinese version of the five-item WFC scale, originally established by Netemeyer et al. [34], was used to investigate participants’ WFC status. The five items are as follows: (1) my work is demanding, which interferes with my home and family life; (2) my job hours make it difficult to fulfil my family responsibilities; (3) I am unable to do things I wish to at home because of my demanding job; (4) my job stress makes it difficult to fulfil my family duties; and (5) work-related duties lead to changes in my plans regarding family activities. Cronbach’s α of the Chinese version of the WFC scale is 0.95 [11]. Each item is scored from 1 (strongly disagree) to 5 (strongly agree), with the total score ranging from 5 to 25. An average score is calculated by summing the scores of the five items, with a high score indicating a high level of WFC. The average scores are further dichotomized into a high level of WFC (score of >3) and low level of WFC (score of ≤3).

3.2.2. Health Status Assessment

SRH of nurses was assessed based on a single question, ‘’In general, how is your health?’’, and the answer was recorded on a 5-point scale, ranging from 1 (very good) to 5 (very poor). In this study, responses were dichotomized into poor SRH (poor or very poor) and good SRH (moderate, good, or very good).
For assessing nurses’ mental health, the 21-item Beck Depression Inventory-II was used; its Chinese version questionnaire was validated, and Cronbach’s α of the scale was 0.93 [35,36]. This questionnaire contained 21 questions, with each question having four possible answers that were sorted according to depressive symptom severity; the scores range from 0 to 63. A high score indicated severe depression symptoms, and a summed score of >14 indicated depression problems [35].

3.2.3. Assessment of Leaving Intentions

The nurses’ turnover intention scale was established based on previous studies [37,38]. Questions included (1) ‘’How often have you thought about leaving your current position?’’, (2) ‘’How often have you thought about finding other nursing jobs?’’, (3) ‘’How often have you thought about finding other nursing-related jobs?’’, and (4) ‘’How often have you thought about giving up the nursing profession completely and starting a different type of job?’’ Answers were recorded on a 5-point scale ranging from 1 (never) to 5 (always). Analyses showed high internal consistency of these four items, with Cronbach’s α of 0.90 and high construct reliability (model fit indexes were as follows: χ2/df = 1.450, GFI = 0.995, AGFI = 0.973, IFI = 0.999, TLI = 0.997, and CFI = 0.999). The summed score was standardized to the 0–100 range, and a standardized score of >50 indicated high leaving intentions.

3.2.4. Assessment of Other Psychosocial Work Characteristics

The psychosocial work characteristics scale consisted of 22 items: job control (nine items), psychological job demands (five items), workplace justice (seven items), and shift work (one item). Psychological job demands and job control were assessed using the Chinese version of the Job Content Questionnaire based on Karasek’s job strain model [28,39,40,41,42,43].
The job control scale consisted of two subscales: skill discretion subscale (six items: learning new things, a high level of skills, nonrepetitive work, creative work, various tasks, and developing one’s abilities) and decision authority subscale (three items: allowed to make own decisions, freedom to make decisions, and opinions influential). Job demands were assessed using five items related to psychological concerns (work fast, excessive work, not enough time, concentrate on job for a long time, and very busy). Workplace justice was assessed using seven items (trust, information reliable, work arranged fairly, rewards arranged fairly, performance evaluated fairly, information during the decision-making process, and respect). During data analysis, job control, psychological work demands, and workplace justice were divided into low, medium, and high according to the scores, and these were included in the regression model. Both scales showed favorable psychometric properties in previous studies [39,40]. Responses for all the aforementioned items were recorded on a 4-point Likert scale, ranging from 1 (strongly disagree) to 4 (strongly agree).
Participants were asked whether they had fixed shifts or night/rotating shifts during the week before the survey, and those with a fixed day shift were classified as day shift workers, whereas the others with night/rotating shifts were classified as night/rotating shift workers.

3.2.5. Ethical Considerations

This study was reviewed and approved by the Institutional Review Board (IRB) of Tungs’ Taichung Metro Harbour Hospital (IRB no.: TTMHH101004).

3.2.6. Data Analysis

Descriptive statistics were performed on the distributions of sociodemographic characteristics, WFCs, health status, leaving intentions, and working conditions. Multivariate logistic regression was performed using SPSS 24.0 (IBM, Armonk, NY, USA) to examine the relationship of WFCs with nurses’ health outcomes and leaving intentions after adjusting for working conditions.

4. Results

Table 1 summarizes the demographic characteristics, working conditions, leaving intentions, and health status of the study participants and the distribution of WFCs score (mean = 3.66, standard deviation = 0.77). Additionally, Pearson correlations showed that WFCs were significantly and positively associated with psychological work demands (r = 0.377, p < 0.01) and leaving intentions (r = 0.350, p < 0.01) (Table 2).
Table 3 shows the results of the multivariate logistic regression analysis of three health outcomes and leaving intentions. The findings of the regression models indicated that a high level of WFC was a significant predictor of poor self-rated health (odds ratio (OR) = 2.819) and depression (OR = 2.809), but not of high leaving intentions, even after adjusting for age, educational level, and adverse psychosocial work factors.

5. Discussion

The score of female nursing staff’s WFC score was higher in this study than in a previous national survey in Taiwan [11]. Moreover, most female nursing staff working in hospitals have high levels of WFCs, which is consistent with the results of previous studies [11,19,29]. In Taiwan, most nurses are of childbearing age. Prolonged working hours, irregular shifts, and high workloads create a high risk of poor SRH. For nurses, the high workload combined with inadequate family-friendly workplace policies and practices may be the root cause of WFCs, poor health of workers, depression, and their intention to leave.
The findings showed that high job requirements, and willingness to leave, were related to WFCs, which is consistent with the results of previous studies [10,11,18]. However, a closer examination of various research results showed that female nurses had high levels of WFCs. Because of their traditional roles in the family, female nurses may be more susceptible to physically harsh working conditions and clinical nursing work characteristics. Further investigation is needed to determine sex-dependant social norms and family-friendly work environments in the workplace and at home and how WFCs are differently experienced [15,19,25].
Inferential statistics after controlling for age, educational level, work shifts, and workplace justice showed that nurses with a WFC score of >3 had considerably high risks of poor SRH and depression. These results are consistent with previous research results, showing that job demands can synergistically increase stress-related health risks [13,15,18,39,44], but not leaving intentions. This study showed that WFCs did not significantly negatively affect turnover intentions, which is inconsistent with previous reports [30,31,33], and this have been caused by the “healthy worker effect”. The ‘’healthy worker effect’’ causes sample selection bias, as those severely affected by WFCs may have already left the workplace and thus not been included in the study [45,46]. Therefore, authors should be cautious when inferring the negative effects of WFCs.
This study has some limitations. First, the cross-sectional survey design precluded direct causal inferences. Causal inferences were restricted to the influence of WFCs on the physical and mental health and turnover intentions of nursing staff. In addition, reverse causality may occur. For example, nursing staff with poor physical and mental health may have poor work performance and be more likely to experience WFCs, or when workers’ physical and mental health is poor, they may perceive increased WFCs, thus influencing research inferences.
Second, participants in the study were current employees; thus, the results of this study could not be generalized to previous employees who may have faced a high risk of WFCs and have already left the workplace. In addition, the self-selection effect might exist that workers’ who had lower WFCs selected this job or remained working as nurses. Our results may have been biased by this healthy worker effect, and therefore the association between high WFC and leaving intentions may have been underestimated. Further research is needed to study WFCs in groups that have already resigned to determine their reasons for leaving.
Third, health outcome measurement was based on self-reports, which may be biased because of participants’ subjective perceptions or feelings. In future, objective measures (e.g., cortisol or other biomarkers) must be used for this type of research.
Fourth, although confounding factors such as demographic characteristics, job changes, and job-related characteristics were controlled for in our statistical model, other potential factors such as an individual’s socioeconomic status and family and workplace characteristics were not considered, including support level and other sources of life stress [11,14,29,47]. Organizational factors such as family-friendly policies and practices may confound or change the connection between workers’ experience of WFCs and their negative effects. Therefore, these organizational factors should also be included in future studies.
Despite these limitations, the study results are still relevant. The authors found that conflicts between work and family are common among nurses and create additional health risks. To improve the health of nurses, the government should strengthen family-friendly policies in the workplace. Specific measures include limiting excessive working hours, regulating the working hours of night shift workers, reducing work-load, and imposing higher penalties for employers who violate legal working conditions. Finally, both institutions and occupational health professionals must identify high risk factors and implement measures to reduce conflicts between work and family life. At an individual level, we advocate that awareness of WFCs’ impact on health should be increased [48], especially among married women. At a household level, support from family members, and on-demand child care services for employed woman, are crucial for reducing WFCs.

Author Contributions

Conceptualization, L.-C.P. and L.-C.L.; methodology, L.-C.P.; software, L.-C.P.; validation, L.-C.L., L.-C.P. and W.-J.C.; formal analysis, L.-C.P.; investigation, L.-C.P., W.-J.C. and K.-R.C.; resources, L.-C.L., L.-C.P. and K.-R.C.; data curation, L.-C.L., L.-C.P. and, W.-J.C.; writing—original draft preparation, L.-C.L.; writing—review and editing,, L.-C.P.; L.-C.L. visualization, L.-C.L., L.-C.P.; supervision, L.-C.P.; project administration, L.-C.P. All authors have read and agreed to the published version of the manuscript.

Funding

This study was supported by the Taipei Medical University, Taiwan (grant number TMU-108-AE1-B30). The funder had no role in the study design, the collection, analysis and interpretation of the data; the writing of the report; or the decision to submit the paper for publication.

Institutional Review Board Statement

The study was conducted according to the ethical guidelines and principles of the Declaration of Helsinki. All subjects gave their informed written consent to the experimental procedures, which were approved by the Tungs’ Taichung Metro Harbour Hospital (IRB no.: TTMHH101004).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to the information is related to personal privacy information, so it is not convenient to provide.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Taiwan Union of Nurses Association (TUNA). Nursing Staff Statistics. Taiwan Union of Nurses Association: Tappei, Taiwan, 2020. Available online: https://www.nurse.org.tw/publicUI/Eng/Y101.aspx (accessed on 5 January 2021).
  2. McGrath, A.; Rcid, N.; Boore, J. Occuptional stress in nursing. J. Nurs. Studi. 2003, 40, 555–565. [Google Scholar] [CrossRef]
  3. Wang, M.-L.; Tsai, L.-J. Work–Family Conflict and Job Performance in Nurses. J. Nurs. Res. 2014, 22, 200–207. [Google Scholar] [CrossRef]
  4. Cheng, S.-Y.; Lin, P.-C.; Chang, Y.-K.; Lin, Y.-K.; Lee, P.-H.; Chen, S.-R. Sleep quality mediates the relationship between work-family conflicts and the self-perceived health status among hospital nurses. J. Nurs. Manag. 2018, 27, 381–387. [Google Scholar] [CrossRef]
  5. Raffenaud, A.; Unruh, L.; Fottler, M.; Liu, A.X.; Andrews, D. A comparative analysis of work–family conflict among staff, managerial, and executive nurses. Nurs. Outlook 2020, 68, 231–241. [Google Scholar] [CrossRef] [PubMed]
  6. Hu, Y.; Lin, P.; Chang, Y.; Hou, W.; Kuo, S.; Lin, Y.; Tung, T. Work stress and work-family conflict contribute to nurse managers’ job burnout from a correlational study. NTJN 2019, 20, 27–37. [Google Scholar]
  7. Galletta, M.; Portoghese, I.; Melis, P.; Gonzalez, C.I.A.; Finco, G.; D’Aloja, E.; Contu, P.; Campagna, M. The role of collective affective commitment in the relationship between work–family conflict and emotional exhaustion among nurses: A multilevel modeling approach. BMC Nurs. 2019, 18, 1–9. [Google Scholar] [CrossRef] [Green Version]
  8. Ghislieri, C.; Gatti, P.; Molino, M.; Cortese, C.G. Work-family conflict and enrichment in nurses: Between job demands, perceived organisational support and work-family backlash. J. Nurs. Manag. 2017, 25, 65–75. [Google Scholar] [CrossRef]
  9. Bernard, R.M.D. Marriage, children burnout contributors. Contemporary OB/GYN 2017, 62, 16–18. Available online: https://search.proquest.com/scholarly-journals/marriage-children-burnout-contributors/docview/1898435312/se-2?accountid=11535 (accessed on 22 February 2021).
  10. Zhao, X.; Namasivayam, K.; Beutell, N.J.; Liu, J.; Wang, F. Chronic Regulatory Focus and Work-Family Conflict among Chinese Workers. Int. J. Environ. Res. Public Heal. 2020, 17, 4526. [Google Scholar] [CrossRef]
  11. Pien, L.C.; Chen, I.S.; Cheng, W.J.; Cheng, Y. Work-to-Family Conflict and its Associations with Workers’ Burnout, Poor Self-Rated Health, and Minor Mental Disorder: A Survey of General Employees in Taiwan. J. Occup Environ. Med. 2020, 62, 588–594. [Google Scholar] [CrossRef] [PubMed]
  12. Kahn, R.L.; Wolfe, D.M.; Quinn, R.P.; Snoek, J.D.; Rosenthal, R.A. Occupational Stress: Studies in Role Conflict and Ambiguity; Wiley: New York, NY, USA, 1964. [Google Scholar]
  13. Greenhaus, J.H.; Beutell, N.J. Sources of conflict between work and family roles. Acad. Manage. Rev. 1985, 10, 76–88. [Google Scholar] [CrossRef]
  14. Zhou, S.; Da, S.; Guo, H.; Zhang, X. Work–family conflict and mental health among female employees: A sequential me-diation model via negative affect and perceived stress. Front. Psychol. 2018, 9, 544. [Google Scholar] [CrossRef]
  15. Leineweber, C.; Baltzer, M.; Hanson, L.L.M.; Westerlund, H. Work-family conflict and health in Swedish working women and men: A 2-year prospective analysis (the SLOSH study). Eur. J. Public Heal. 2012, 23, 710–716. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  16. Zhang, M.; Griffeth, R.W.; Fried, D.D. Work-family conflict and individual consequences. J. Manag. Psychol. 2012, 27, 696–713. [Google Scholar] [CrossRef]
  17. Ju, Y.J.; Park, E.-C.; Ju, H.-J.; Lee, S.A.; Lee, J.E.; Kim, W.; Chun, S.-Y.; Kim, T.H. The influence of family stress and conflict on depressive symptoms among working married women: A longitudinal study. Heal. Care Women Int. 2017, 39, 275–288. [Google Scholar] [CrossRef]
  18. Gisler, S.; Omansky, R.; Alenick, P.R.; Tumminia, A.M.; Eatough, E.M.; Johnson, R.C. Work-life conflict and employee health: A review. J. Appl. Biobehav. Res. 2018, 23, e12157. [Google Scholar] [CrossRef]
  19. Zurlo, M.C.; Vallone, F.; Smith, A.P. Work-family conflict and psychophysical health conditions of nurses: Gender dif-ferences and moderating variables. Jpn. J. Nurs. Sci. 2020, 17, e12324. [Google Scholar] [CrossRef] [PubMed]
  20. Wang, Y.; Peng, J. Work–family conflict and depression in Chinese professional women: The mediating roles of job sat-isfaction and life satisfaction. Int. J. Ment. Health Addiction. 2017, 15, 394–406. [Google Scholar] [CrossRef]
  21. Allen, T.D.; Herst, D.E.L.; Bruck, C.S.; Sutton, M. Consequences associated with work-to-family conflict: A review and agenda for future research. J. Occup. Heal. Psychol. 2000, 5, 278–308. [Google Scholar] [CrossRef]
  22. Adams, G.A.; Jex, S.M. Relationships between time management, control, work-family conflict, and strain. J. Occup. Heal. Psychol. 1999, 4, 72–77. [Google Scholar] [CrossRef]
  23. Michel, J.S.; Kotrba, L.M.; Mitchelson, J.K.; Clark, M.A.; Baltes, B.B. Antecedents of work-family conflict: A meta-analytic review. J. Organ. Behav. 2010, 32, 689–725. [Google Scholar] [CrossRef]
  24. Judge, T.A.; Colquitt, J.A. Organizational Justice and Stress: The Mediating Role of Work-Family Conflict. J. Appl. Psychol. 2004, 89, 395–404. [Google Scholar] [CrossRef] [Green Version]
  25. Swandarujati, M.; Nurfitri, T.; Anggraeni, A.I. Effect of Organizational Justice on Stress with Work-Family Conflict as a Mediating Variable. J. Res. Manag. 2020, 2, 11–20. [Google Scholar] [CrossRef]
  26. Pien, L.-C.; Cheng, Y.; Cheng, W.-J. Psychosocial safety climate, workplace violence and self-rated health: A multi-level study among hospital nurses. J. Nurs. Manag. 2018, 27, 584–591. [Google Scholar] [CrossRef]
  27. Cheng, Y.; Chen, I.-S.; Chen, C.-J.; Burr, H.; Hasselhorn, H.M. The influence of age on the distribution of self-rated health, burnout and their associations with psychosocial work conditions. J. Psychosom. Res. 2013, 74, 213–220. [Google Scholar] [CrossRef]
  28. Cheng, Y.; Chen, I.-S.; Burr, H.; Chen, C.-J.; Chiang, T.-L. Changes in Psychosocial Work Conditions in Taiwanese Employees by Gender and Age from 2001 to 2010. J. Occup. Heal. 2013, 55, 323–332. [Google Scholar] [CrossRef] [Green Version]
  29. Hsu, H.C. Age Differences in Work Stress, Exhaustion, Well-Being, and Related Factors from an Ecological Perspective. Int. J. Environ. Res. Public Health 2019, 16, 50. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  30. Varma, M.M.; Kelling, A.S.; Goswami, S. Enhancing healthcare quality by promoting work-life balance among nursing staff. J. Hosp. Adm. 2016, 5, p58. [Google Scholar] [CrossRef] [Green Version]
  31. Pan, S.-Y.; Yeh, Y.-J. The crossover effect of work–family conflict among hotel employees. Int. J. Contemp. Hosp. Manag. 2019, 31, 812–829. [Google Scholar] [CrossRef]
  32. Dewi, I.G.A.N.P.; Dewi, I.M. Job stress as a mediation on the effect of work-family conflict on turnover intention. Am. J. Human.Soc. Sci. Res. 2019, 3, 197–202. [Google Scholar]
  33. Rasheed, M.; Iqbal, S.; Mustafa, F. Work-family conflict and female employees’ turnover intentions. Gend. Manag. Int. J. 2018, 33, 636–653. [Google Scholar] [CrossRef]
  34. Netemeyer, R.G.; Boles, J.S.; McMurrian, R. Development and validation of work–family conflict and family–work conflict scales. J. Appl. Psychol. 1996, 81, 400–410. [Google Scholar] [CrossRef]
  35. Beck, A.T.; Steer, R.A.; Brown, G.K. Beck Depression Inventory-II, BDI-II (H. Chen, Trans.); Psychological Corporation: Taipei, Taiwan, 2000. [Google Scholar]
  36. Beck, A.T.; Steer, R.A.; Brown, G.K. Beck Depression Inventory-II. San Antonio 1996, 78, 490–498. [Google Scholar]
  37. Flinkman, M.; Leino-Kilpi, H.; Salanterä, S. Nurses’ intention to leave the profession: Integrative review. J. Adv. Nurs. 2010, 66, 1422–1434. [Google Scholar] [CrossRef] [PubMed]
  38. Flinkman, M.; Laine, M.; Leino-Kilpi, H.; Hasselhorn, H.-M.; Salanterä, S. Explaining young registered Finnish nurses’ intention to leave the profession: A questionnaire survey. Int. J. Nurs. Stud. 2008, 45, 727–739. [Google Scholar] [CrossRef]
  39. Cheng, Y.; Chen, C.-J. Modifying effects of gender, age and enterprise size on the associations between workplace justice and health. Int. Arch. Occup. Environ. Heal. 2012, 87, 29–39. [Google Scholar] [CrossRef] [PubMed]
  40. Cheng, Y.; Huang, H.-Y.; Li, P.-R.; Hsu, J.-H. Employment Insecurity, Workplace Justice and Employees’ Burnout in Taiwanese Employees: A Validation Study. Int. J. Behav. Med. 2011, 18, 391–401. [Google Scholar] [CrossRef]
  41. Yeh, W.Y.; Cheng, Y.; Chen, C.J.; Hu, P.; Kristensen, T.S. Psychometric properties of the Chinese version of the Copenhagen Burnout Inventory among Taiwanese employees from two enterprises. Int. J. Behav. Med. 2007, 14, 126–133. [Google Scholar] [CrossRef]
  42. Cheng, Y.; Luh, W.-M.; Guo, Y.-L. Reliability and validity of the Chinese version of the Job Content Questionnaire in Taiwanese workers. Int. J. Behav. Med. 2003, 10, 15–30. [Google Scholar] [CrossRef]
  43. Karasek, R.; Theorell, T. Healthy Work: Stress, Productivity, and the Reconstruction of Working Life; Basic Books: New York, NY, USA, 1990. [Google Scholar]
  44. Rafique, H.; Masood, S.; Ahmad, M. Role of self-compassion in work-family conflict and psychological well-being among working men and women. J. Behav. Sci. 2018, 28, 131–145. [Google Scholar]
  45. Fornalski, K.W.; Dobrzyński, L. The Healthy Worker Effect and Nuclear Industry Workers. Dose-Response 2010, 8, 125–147. [Google Scholar] [CrossRef] [PubMed]
  46. Li, C.-Y.; Sung, F.-C. A review of the healthy worker effect in occupational epidemiology. Occup. Med. 1999, 49, 225–229. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  47. Amstad, F.T.; Meier, L.L.; Fasel, U.; Elfering, A.; Semmer, N.K. A meta-analysis of work–family conflict and various outcomes with a special emphasis on cross-domain versus matching-domain relations. J. Occup. Heal. Psychol. 2011, 16, 151–169. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  48. Hollanda, P. Antecedents and Outcomes of Work-Family Conflict and Work-Family Enrichment: A Longitudinal, Multilevel, and Multimethod Study. In Contributions to Management Science; Metzler, J.B., Ed.; Springer: Cham, Switzerland, 2019; pp. 223–249. [Google Scholar]
Table
Table 1. Demographic characteristics of study participants (N = 200).
Table 1. Demographic characteristics of study participants (N = 200).
VariableMean/nSD/%
Work experience (years)6.795.26
Age (years)28.505.29
 20~3014371.5%
 ≥315728.5%
Educational level
 Nursing high school and junior college9346.5%
 University and above10753.5%
Work shift
 Fixed day shift2512.5%
 Night and rotating shift17587.5%
Work-family conflict3.660.77
 Low (≤3)4924.5%
 High (>3)15175.5%
Job control
 High5326.5%
 Medium8140.5%
 Low6633.0%
Psychological work demands
 High7939.5%
 Medium5427.0%
 Low6733.5%
Workplace justice
 High5929.5%
 Medium6030.0%
 Low8140.5%
Depression
 Normal10552.5%
 Mild depression3718.5%
 Moderate depression3216.0%
 Severe depression2613.0%
Self-reported health
 Good13869.0%
 Poor6231.0%
Leaving intentions
 Low9145.5%
 High10954.5%
SD, standard deviation.
Table
Table 2. Correlation of work–family conflicts (WFCs) with job control, psychological work demands, and leaving intentions (N = 200).
Table 2. Correlation of work–family conflicts (WFCs) with job control, psychological work demands, and leaving intentions (N = 200).
Variable1234
1. WFCs1
2. Job control−0.1351
3. Psychological work demands0.377 **0.0761
4. Leaving intentions0.350 **−0.224 **0.318 **1
** p < 0.01.
Table
Table 3. Odds ratio (OR) for poor self-rated health (SRH), depression, and high leaving intentions of nurses (N = 200).
Table 3. Odds ratio (OR) for poor self-rated health (SRH), depression, and high leaving intentions of nurses (N = 200).
VariablePoor SRHDepressionHigh Leaving Intentions
OR95% CIOR95% CIOR95% CI
High WFC (ref. low)2.819 *(1.140, 6.972)2.809 **(1.329, 5.939)1.634(0.793, 3.370)
Job control
 High1 1 1
 Medium1.290(0.578, 2.877)0.833(0.392, 1.773)1.626(0.748, 3.535)
 Low0.944(0.412, 2.163)1.076(0.496, 2.336)2.756 *(1.222, 6.215)
Psychological work demands
 Low1 1 1
 Medium1.328(0.536, 3.292)0.388 *(0.171, 0.882)1.624(0.733, 3.596)
 High2.630 *(1.120, 6.175)0.849(0.391, 1.845)3.777 **(1.677, 8.504)
* p < 0.05; ** p < 0.01; Age, educational level, shift work, and workplace justice were controlled for in the regression model; WFC, work–family conflict; CI, confidence interval.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Pien, L.-C.; Cheng, W.-J.; Chou, K.-R.; Lin, L.-C. Effect of Work–Family Conflict, Psychological Job Demand, and Job Control on the Health Status of Nurses. Int. J. Environ. Res. Public Health 2021, 18, 3540. https://doi.org/10.3390/ijerph18073540

AMA Style

Pien L-C, Cheng W-J, Chou K-R, Lin L-C. Effect of Work–Family Conflict, Psychological Job Demand, and Job Control on the Health Status of Nurses. International Journal of Environmental Research and Public Health. 2021; 18(7):3540. https://doi.org/10.3390/ijerph18073540

Chicago/Turabian Style

Pien, Li-Chung, Wan-Ju Cheng, Kuei-Ru Chou, and Li-Chiu Lin. 2021. "Effect of Work–Family Conflict, Psychological Job Demand, and Job Control on the Health Status of Nurses" International Journal of Environmental Research and Public Health 18, no. 7: 3540. https://doi.org/10.3390/ijerph18073540

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop