title: Combined use of job stress models and self-rated health in nursing.
abstract: OBJECTIVE
  To identify combinations of two models of psychosocial stress at work among nursing teams and their associations with self-rated health.
  
  
  METHODS
  This was a cross-sectional study among workers at three public hospitals in the municipality of Rio de Janeiro, Southeastern Brazil (N = 1307). In 2006, a multidimensional questionnaire including two scales for measuring stress at work (demand-control and effort-reward imbalance models) was administered. Partial and complete (including social support at work) demand-control models were considered, along with partial and complete (including excessive commitment to work) effort-reward models. Multiple logistic regression models were used to estimate adjusted odds ratios and their respective 95% confidence intervals.
  
  
  RESULTS
  The dimensions of both models were independently associated with self-rated health, with odds ratios between 1.70 and 3.37. The partial demand-control model was less associated with health (OR = 1.79; 95%CI 1.26;2.53) than was the partial effort-reward imbalance model (OR = 2.27; 95%CI 1.57;3.30). Incorporation of social support and excessive commitment to work increased the strength of the demand-control and effort-reward imbalance models, respectively. Increased strength of association was observed when the two partial models were combined.
  
  
  CONCLUSIONS
  The results indicate that the effort-reward imbalance model performed better for this specific group and for the outcome evaluated, and that there was an advantage in using complete models or combinations of partial models.
authors.affiliation: Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. rohgriep@ioc.fi ocruz.br
authors.forename: Rosane Härter
authors.initials: RH
authors.lastname: Griep
authors.forename: Lúcia
authors.initials: L
authors.lastname: Rotenberg
authors.forename: Paul
authors.initials: P
authors.lastname: Landsbergis
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Vasconcellos-Silva
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D059026:Diagnostic Self Evaluation; D004812:Epidemiologic Methods; D005260:Female; D006304:Health Status; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008960:Models, Psychological; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D016272:Occupational Health / Q000706:statistics & numerical data; D012201:Reward; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D016526:Workload / Q000523:psychology* / Q000706:statistics & numerical data; D017132:Workplace / Q000523:psychology