ArticleJournal of occupational medicine and toxicology (London, England)2025
Effort-reward-imbalance, burnout, and physical pain mediate the relationship between overcommitment and depression in German Emergency Medical Technicians.
Article in Journal of occupational medicine and toxicology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Prevalence of musculoskeletal disorders among police officers from an organizational unit of a German federal state police force.Journal of occupational medicine and toxicology (London, England) · 2026Article
- Musculoskeletal complaints and psychosocial stress factors in emergency medical services: a differentiated gender comparison.Journal of occupational medicine and toxicology (London, England) · 2026Article
- The relationship between post-traumatic stress disorder, occupational stress, occupational burnout, and mental health in football referees: a national cross-sectional survey in China.Frontiers in public health · 2025Article
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Authors and funding
4 authors.
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Abstract
backgroundOvercommitment (OC) is highly prevalent in health care employees, and may predict depression symptoms. The literature suggests that the relationship between OC and depression is mediated by Effort-Reward-Imbalance (ERI), burnout and physical pain. This study tested a two-step mediation effect between OC and depression by ERI in a first, and burnout and physical pain in a second step using a cohort of German Emergency Medical Technicians (EMTs).
methodsA cross-sectional study was carried out on a volunteer sample of 303 EMTs in Germany. OC and ERI were assessed using the ERI questionnaire, burnout with the Maslach Burnout Inventory, physical pain with the Short Form 36, and depression with the BDI-II. The relationship between these variables was tested using a mediation analysis.
resultsWe found a partial mediation effect between OC and depression via ERI, burnout (emotional exhaustion, personal accomplishment) and physical pain. The mediation effect of emotional exhaustion is significantly higher than those of depersonalization and physical pain.
conclusionsThe partial mediation effect suggests the validity of our model assumptions, but also indicates direct relationships between variables (i.e. OC, ERI and depression). The identification of emotional exhaustion as key mediator implies that prevention and intervention approaches in EMTs should be based on this indicator.
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