title: A modified model of pharmacists' job stress: the role of organizational, extra-role, and individual factors on work-related outcomes.
abstract: BACKGROUND
  Understanding the effects of job stress continues to be a concern for health-care providers as workload and personnel needs increase.
  
  
  OBJECTIVE
  The overall objective of this study was to test a direct effects model of job stress that examines the characteristics of the organizational environment (interpersonal interactions, environmental aspects, the level of compensation and advancement, role stress, and availability of alternative jobs); extra-role factors (work-home conflict); job stress; individual factors (career commitment); and the work-related psychological outcomes of job satisfaction, organizational commitment, and job turnover intention.
  
  
  METHODS
  A cross-sectional mail survey was sent to a nationwide random sample of 4895 licensed pharmacists in the United States. Previously validated summated Likert-type scales measured each of the study variables. Data analyses included descriptive statistics, and exploratory and confirmatory factor analyses. Structural equation modeling was used to estimate the final model.
  
  
  RESULTS
  A response rate of 46% was achieved. Psychometric analyses indicated acceptable reliability and validity. The study model fit the data well (CFI[comparative fit index] = 0.90, RMSEA[root mean square error of approximation] = 0.05). Organizational factors in the form of role overload (standardized beta = 0.45) and conflict (0.31) and ease of finding a job with better interpersonal characteristics (0.26) had the largest effects on job stress. Interpersonal characteristics were also one of the strongest predictors of job satisfaction (-0.61) and organizational commitment (-0.70). Work-home conflict directly affected job turnover intention (0.11) and career commitment (-0.16). Other significant, but sometimes, opposite direct effects were found. Job satisfaction and organizational commitment directly affected job turnover intention.
  
  
  CONCLUSIONS
  Given the increased demand for pharmacy services, health-care organizations will benefit from increasing positive and reducing negative work outcomes. Increased focus on enhancing interpersonal interactions, developing commitment to the profession, and greater consideration of nonwork factors could help pharmacists better manage their work environments. Future research should continue to refine these models to further enhance our understanding of the effects of job stress in the health professional workplace.
authors.affiliation: University of Michigan, College of Pharmacy, Ann Arbor, MI 48109-1065, USA. gaitherc@umich.edu
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Gaither
authors.forename: Abir A
authors.initials: AA
authors.lastname: Kahaleh
authors.forename: William R
authors.initials: WR
authors.lastname: Doucette
authors.forename: David A
authors.initials: DA
authors.lastname: Mott
authors.forename: Craig A
authors.initials: CA
authors.lastname: Pederson
authors.forename: Jon C
authors.initials: JC
authors.lastname: Schommer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015279:Organizational Culture; D010595:Pharmacists / Q000523:psychology*; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000209:etiology*; D014481:United States