title: Working conditions, self-perceived stress, anxiety, depression and quality of life: a structural equation modelling approach.
abstract: BACKGROUND
  The relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia.
  
  
  METHODS
  The validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation.
  
  
  RESULTS
  The results of the SEM supported the hypothesized structural model (chi2 = 22.801, df = 19, p = 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF.
  
  
  CONCLUSIONS
  These findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers.
authors.affiliation: Division of Occupational Medicine, Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. ruslinordin@yahoo.com
authors.forename: Bin Nordin
authors.initials: BN
authors.lastname: Rusli
authors.forename: Bin Abdin
authors.initials: BA
authors.lastname: Edimansyah
authors.forename: Lin
authors.initials: L
authors.lastname: Naing
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D001336:Automobiles; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D006801:Humans; D007588:Job Satisfaction; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D054526:Men's Health; D009784:Occupational Diseases / Q000453:epidemiology; D016272:Occupational Health / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance / Q000523:psychology; D016526:Workload / Q000523:psychology*