ArticleBMC public health2016
Effort-reward imbalance and perceived quality of patient care: a cross-sectional study among physicians in Germany.
Article in BMC public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Meta-analysis of effort-reward imbalance prevalence among physicians.International archives of occupational and environmental health · 2022Pooled it
- Exploring the association between social support and reward satisfaction: the mediating role of multi-dimensional psychological capital.BMC health services research · 2026Article
- Institutional barriers and professional integration of physicians with an Arab migration background in Germany: a qualitative study.Globalization and health · 2026Article
- A systematic review and meta-analysis of depressive symptoms and work-ralated psychoacial factors among healthcare workers.Discover mental health · 2026Review
- Psychological Empowerment as a Mediator of Effort-Reward Imbalance Effects on Burnout, Anxiety and Depression Among Nursing Home Professionals: A Cross-Sectional Study.Journal of advanced nursing · 2025Article
- Effort-reward-imbalance, burnout, and physical pain mediate the relationship between overcommitment and depression in German Emergency Medical Technicians.Journal of occupational medicine and toxicology (London, England) · 2025Article
- Work-related stress and its associated factors among primary care doctors in Malaysia during the COVID-19 pandemic.BMC primary care · 2025Article
- Unveiling social relationships: exploring the importance of relationships as a moderator of the link between effort-reward imbalance and leader-member exchange among healthcare professionals.BMC public health · 2024Article
- Job satisfaction and work stress among physicians in Norway and Germany-A cross-sectional study.PloS one · 2024Article
- Coronary microvascular function in male physicians with burnout and job stress: an observational study.BMC medicine · 2023Observational
- Article
- Managers perception of hospital employees' effort-reward imbalance.Journal of occupational medicine and toxicology (London, England) · 2023Article
- Article
- Psychosocial working conditions as determinants of concerns to have made important medical errors and possible intermediate factors of this association among medical assistants - a cohort study.BMC health services research · 2022Article
- Nationwide Study on Stress Perception Among Surgical Residents.World journal of surgery · 2022Article
- Exploring effort-reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study.Global health research and policy · 2022Article
- Work-Related Intervention Needs of Medical Assistants and How to Potentially Address Them according to Supervising General Practitioners: A Qualitative Study.International journal of environmental research and public health · 2022Article
- Association between social supports and negative emotions among pediatric residents in China: The chain-mediating role of psychological resilience and burnout.Frontiers in public health · 2022Article
- Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)-A Cross-Sectional Study among Medical Assistants.International journal of environmental research and public health · 2021Article
- Perception of safety from workplace violence affects job satisfaction among doctors practicing modern medicine in India: A nationwide survey.Journal of family medicine and primary care · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWork stress may impair physicians' ability to provide high quality patient care. Prior research remains however sparse and has insufficiently explored explanations for this relationship. It has been suggested that physicians' poor mental health is one potential explanatory factor. We drew on a well-established model to measure work stress (the effort-reward imbalance [ERI] model) in order to test this hypothesis. Further, to address another research gap and to potentially inform the development of better-targeted interventions, we aimed to examine associations of individual ERI constructs with the quality of care.
methodsWe used cross-sectional data, which had been collected in 2014 among 416 physicians in Germany. ERI constructs (i.e. effort, reward, the ERI ratio, and overcommitment) were measured by the established 23-item questionnaire. Physicians' perceptions of quality of care were assessed by a six-item instrument inquiring after poor care practices or attitudes. Physicians' mental health was operationalized by the state scale of the Spielberger's State-Trait Depression Scales. We used both continuous and categorized dependent and independent variables in multivariable linear and logistic regression analyses.
resultsBoth an increasing ERI ratio and increasing effort were associated with poorer quality of care while increasing rewards were related to better care. Physicians' depressive symptoms did not affect these associations substantially. Associations with overcommitment were weak and attenuated to non-significant levels by correction for depressive symptoms. The level of overcommitment did not modify associations between the ERI ratio and quality of care.
conclusionsOur study suggests that high work-related efforts and low rewards are associated with reports of poorer patient care among physicians, irrespectively of physicians' depressive symptoms. Quality of patient care may thus be improved by concurrently reducing effort and increasing rewards among physicians.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.