Work Organization and Stress
Research Areas:
Work Organization involves the way in which work is structured and organized at the level of the worksite, the firm, and even the labor market. The conceptual model of stress developed by the Work and Health Research Center illustrates how health care worker stress and well-being is a consequence of societal forces, institutional structures and the way work is organized. This model suggests that it is important to intervene at all three levels – societally, institutionally and at the level of the workplace. Aspects of the organization of work (OOW) include: long work hours, irregular working hours, payment systems (e.g., piece-rate), task-level work content (e.g., repetitive, short-cycle operations), management practices (e.g., lean production methods), as well as the broader psychosocial work environment including job demands, work control, social support, and effort/reward imbalance. Work organization exposures affect all workers, including both industrial and service sector workers. There has been a growing awareness in many disciplines that the nature of work has undergone a profound transformation in recent decades, not the least of which has included a move from the production of goods to a largely service-based workforce.
Work stress is one of the most significant and rapidly growing occupational health problems in the modern workplace. Approximately 25% of workers in North America and Europe are exposed to high levels of stress. Health care workers in general and nurses in particular are one of the most stressed of occupational groups. Stress is best understood as a process that begins with environmental demands (stressors) which may trigger acute emotional and physiological reactions, that if repeated and prolonged give rise to mental, biological and behavioral effects and may lead eventually to long term health consequences such as chronic disease, and eventually, death. Throughout the stress process individual coping strategies or environmental resources (like social support) serve as protective moderators of stress. Human service professionals like social workers, teachers and nurses are often involved in emotionally demanding daily encounters with their clients or patients. Research has shown that over time the intensity of these frequent emotional encounters can lead to burnout -- particularly when human service workers have high case loads and are not provided with sufficient recognition, respect or social, technical and administrative support for the work that they do.
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Grants:
“Health Issues of Female Mexican Crab Pickers” National Institute
for Occupational Safety and Health/Johns Hopkins School of Hygiene and Public Health. October
30, 2004 – August 1, 2006. This qualitative study of migrant workers focused on a
range of work-related health complaints, with an emphasis on working conditions and injuries to
the hands and upper extremities. PI: Susan Antol; Co-investigator: Karen Kauffman, Jane Lipscomb.
“Do Organizational Factors Influence Both Patient and Work Safety?” 2001-2004, Agency for Healthcare Research and Quality (AHRQ) Using administrative data sets, we assessed system level factors in hospitals (e.g. staffing, ownership) and nursing in relation to adverse patient outcomes and worker injury for the years (PI) A. Trinkoff. (R01 HS11990)
Measurement of Job-Stress Among Medical Laboratory Workers: Congruence Between Subjective and Objective Measures. DRIF 2003. The aim of this study is to estimate the validity of survey measures for describing physical and psychosocial demands of work by using objective observations of work and salivary cortisols to provide additional measures of work stress. (PI) Jeanne Geiger-Brown.
Development of a Survey for Medical Technologist Occupational Research. NIOSH Educational Research Center Grant, 2002, The aim of this study is to explore the physical and psychosocial work demands of laboratory workers and develop a survey for future epidemiologic surveillance. (PI) Jeanne Geiger-Brown.
Work Organization and Health Among Home Care Workers CDC/NIOSH2001-2006 The aims of this study are to examine the association between job demands, control at work, and the prevalence of symptoms of major depression and musculoskeletal disorders among home care workers. (PI) Carles Muntaner, (Co-I), Jeanne Geiger Brown. (R01 OH07440)
“The Casa Grand Study”. The Spanish National Institute of Health, Research Grant, 1997-1999. This study examined the impact of psychosocial work organization on the physical heath and mental well being of public employees performing service work in Barcelona, Spain. (PI) S. Moncada, (Co-I) Jeffrey V. Johnson.
Substance Use Among Registered Nurses. National Institute on Drug Abuse (NIDA) 1993-1998. This study was designed to identify nursing specialties and subgroups with higher odds of substance use and to generate estimates of the prevalence of substance abuse. Registered nurses (n=4438) were surveyed anonymously as to their substance use and working conditions. (PI) A. Trinkoff, (R01 DA07434).
Occupational Health Psychology Postdoctoral Training Grant. American Psychological Association and National Institute for Occupational Safety and Health. Training Grant Award, 1996-1998. This grant provided support for an interdisciplinary post-doctoral training program in work organization and health at Johns Hopkins School of Public Health. (PI) Jeffrey V. Johnson.
Assessment of Research on the Relationship Between Occupational Psychosocial Factors and Work-Related Cardiovascular Disorders. National Institute of Occupational Safety and Health (CDC/NIOSH) 1994-1996. This study involved an extensive assessment of longitudinal data resources within NIOSH and throughout the U.S. federal system that could be utilized in prospective studies of examining the relationship between work organization exposure and cardiovascular disease risk. (PI) Jeffrey V. Johnson. (Research Contracts No. 0009437615 & 0009452847).
Developing a Questionnaire to Examine Psychosocial Work Environment Factors in a Study of Back Pain and Injury Prevention. National Institute of Occupational Safety and Health (NIOSH) 1994-1995. This study developed a questionnaire for a large study that evaluated the effectiveness of back belt use in preventing low back injury in Walmart employees. (PI) Jeffrey V. Johnson, (Research Contract 009452847).
Work Organization and Cardiovascular Disease. National Heart Lung and Blood Institute (NHLBI), 1988-1993. This was a longitudinal prospective study of the relationship between cardiovascular morbidity and mortality and long term exposure to work organization characteristics such as psychological and physical demands, work control, work social support and hazardous exposures in a cohort of 24,000 Swedish men and women. (PI) Jeffrey V. Johnson, (PI R29 HL39633)
Work Stress Over the Life-Course. Swedish Work Environment Fund, 1988-1994. This study developed quantitative methods to track occupational career trajectories and to develop models of accumulative work organization exposure in a sample of 13,779 Swedish men and women. (PI) Jeffrey, V. Johnson. (Research Grant 88-0416).
Cardiovascular Disease in Black Vs. White Physicians. National Heart Lung and Blood Institute (NHLBI)NIH/NHLBI 1988-1993. This study examined racial differences in social and biomedical risk factors between Black and White medical graduates. A prospective component of the study examined the impact of psychosocial job strain on mental health among Johns Hopkins Medical graduates. (PI) .M. Klag, (Co-I) Jeffrey V. Johnson. (RO1 HL37394).
Back Injuries in Municipal Employees. National Institute of Occupational Safety and Health (CDC/NIOSH)1988-1992. This was a case-control study of psychosocial and ergonomic risk factors for low back injury among municipal workers in Baltimore. (PI) S. Baker, (Co-I) Jeffrey V. Johnson. (RO1 OH02574).
Publications:
Johnson, J.V. The Growing Imbalance: Class, Work and Health in an Era of Increasing Inequality. In Schnall, P., et al (eds.) The Way We Work and Its Impact on Health. Amityville, New York: Baywood Publishing Company, in press.
Johnson, J.V. Globalization, Workers’ Control and Psychosocial Work Organization. Scandinavian Journal of Work Environment and Health, in press.
Johnson, J.V. Occupational Stress in Nursing: A literature Review. In Raphael, S., Malvarez Silvina M. (Eds.) Quality of Care in Mental Health: Building Towards Evidence-Based Practice Through Best Practices, Washington, D.C.: Pan American Health Organization, in press.
Johnson, J.V. Transforming the Causes of Stress in Nursing Practice at the Personal, Organizational and Societal Levels: A constructed case-study narrative. In Raphael, S., Malvarez Silvina M. (Eds.) Quality of Care in Mental Health: Building Towards Evidence-Based Practice Through Best Practices, Washington, D.C.: Pan American Health Organization, in press.
Johnson, J.V., Lipscomb, J. Long Working Hours, Occupational Health, and the Changing Nature of Work Organization. American Journal of Industrial Medicine, 49(11), 921-929, 2006.
Muntaner, C., Geiger-Brown, J. How social injustice affects mental health. In Sidel, V. and Levy B. Social Injustice and Public Health. Oxford University Press, 2005.
Geiger-Brown, J., Trinkoff, A.M., Rempher, K., McPhaul, K., Brady B., Lipscomb, J.A., Muntaner, C. Nurses' inclination to report work-related injuries. AAOHN Journal, 53:213-217, 2005.
Johnson, J.V. Participatory action research and the struggle for social justice in the workplace. New Solutions, 15(1), 61-66, 2005.
Johnson, J.V. Work Stress. In Levy, B., Wagner, G., Rest, K., Weeks, J. (Eds.) Preventing Occupational Disease and Injury, 2nd Edition. Washington, D.C., The American Public Health Association, 2005.
Trinkoff, A.M., Johantgen, M., Muntaner, C., Le, R. The relationship between staffing and worker injury in nursing homes. American Journal of Public Health. 95(7): 1220-1225, 2005.
Geiger-Brown, J., Trinkoff, A., Rempher, K., McPhaul, K., Brady, B., Lipscomb, J., Muntaner, C. (Accepted for publication). Inclination to report work-related injuries among nurses. AAOHN Journal, 2004.
Lipscomb, J., Trinkoff, A., Geiger-Brown, J., Brady, B. Health care system changes and reported musculoskeletal disorders among registered nurses. American Journal of Public Health, 94(8): 1431-1435, 2004.
Geiger-Brown, J., Muntaner, C., Lipscomb, J., Trinkoff, A. Demanding work schedules and mental health in nursing assistants working in nursing homes, Work and Stress, 18(4): 292-304, 2004.
Arteaga, S., Geiger-Brown, J. Muntaner, C., Trinkoff, A., Lipscomb, J., Delp, L. Home care work organization and health: Do Hispanic women have different concerns? Hispanic Health Care International, 1(3): 1-7, 2003.
Geiger-Brown, J., Smith, L.L., Trinkoff, A.M. Nurses in recovery: The burden of life problems and confidence to resist relapse. Journal of Addictions Nursing, 14, 133-137, 2003.
Geiger-Brown, J., Trinkoff, A., Nielsen, K., Lirtmunlikaporn, S., Brady, B. Nurses' perception of their work environment, health and well-being. AAOHN Journal, 52(1), 16-22, 2003.
Trinkoff, A.M., Storr, C.L. & Lipscomb, J.A. Physically demanding work and inadequate sleep, pain medication use, and absenteeism in registered nurses. Journal of Occupational and Environmental Medicine, 43(4): 355-363, 2001.
Storr, C.L., Trinkoff, A.M., Hughes, P. Similarities of substance use between medical and nursing specialties. Substance Use & Misuse. 35(9), 1-27, 2000.
Trinkoff, A. M., Zhou, P. Q., Storr, C. L., & Soeken, K. L. Workplace access, negative proscriptions, job strain, and substance use in registered nurses. Nursing Research, 49(2), 83-90, 2000.
Corey-Lisle, P., Tarzian, A.J., Cohen, M.Z., Trinkoff, A.M. Health care reform: Its effects on nurses. Journal of Nursing Administration, 29(3), 30-37, 1999. Reprinted in: Harrington, C., & Estes, C.L. (Eds.) Health Policy: Crisis and Reform in the U.S. Health Care Delivery System (The Jones and Bartlett Series in Health Sciences) Third Edition. Jones & Bartlett Publishers. 2000.
Myers, A.H., Baker, S.P., Li, G., Smith, G., Wiker, S., Liang, K-Y, Johnson, J.V. Back injury in municipal workers: A case-control study. American Journal of Public Health, 89(7), 1036-1041, 1999.
Storr, C. L., Trinkoff, A. M. & Anthony, J. C. Job strain and non-medical drug use. Drug and Alcohol Dependence, 55(1-2): 45-51. 1999.
Trinkoff, A. M., Storr, C. L., & Wall, M. P. Prescription-type drug misuse and workplace access among nurses. Journal of Addictive Diseases. 18(1), 9-17, 1999.
Trinkoff, A. M., Zhou, P.Q., Storr, C. L. Estimation of the prevalence of substance use problems among nurses using capture-recapture methods. Journal of Drug Issues. 29(1), 187-198, 1999.
Graves, P.L., Wang, N-Y, Mead, L.A., Johnson, J.V., Klag, M.J. Youthful precursors of midlife social support. Journal of Personality and Social Psychology, 74(5), 1329-36, 1998.
Hammar, N., Alfredsson, L., Johnson, J.V. Job strain, social support at work, and incidence of myocardial infarction. Occupational and Environmental Medicine, 55(8), 548-553, 1998.
Theorell, T., Hallquist, J., Reuterwall, C., Fredlund, P., Emlund, N., Johnson, J.V. Decision latitude, job strain, and myocardial infarction. American Journal of Public Health, 88(3), 382-388, 1998.
Trinkoff, A. M. & Storr, C. L. Substance use among nurses: differences between specialties. American Journal of Public Health. 88,581-585, 1998.
Trinkoff, A.M. & Storr, C.L. Substance use among nurses:differences between specialties. Journal of Addictions Nursing, 10, 77-84. (Reprinted from American Journal of Public Health 1998; 88:581-585), 1998.
Trinkoff, A. M. & Storr, C. L. Work schedule characteristics and substance use among nurses. American Journal of Industrial Medicine, 34: 266-271, 1998.
Johnson, J.V. Empowerment in future worklife. Scandinavian Journal of Work Environment and Health, 23 4:23-28, 1997.
Nishiyama, K., Johnson, J.V. Karoshi--death from overwork: Occupational health consequences of Japanese production management. International Journal of Health Services, 27, 625-641, 1997.
Theorell, T., Johnson, J.V. Chronic outcomes: Cardiovascular disease, pages 34.58-34.59 in ILO Encyclopedia of Occupational Health and Safety. Geneva, Switzerland: International Labour Office, 1997.
Johnson, J.V., et al. The psychosocial Work Environment of Physicians. In: M.A. Bowman (ed), The Year Book of Family Practice, Mosby-Year Book, Inc., 1997.
Trinkoff, A. M. & Storr, C. L. Collecting substance use data with an anonymous mailed survey. Drug and Alcohol Dependence, 48(1), 1-8, 1997.
Johnson, J.V., Hall, E.M. The dialectic between conceptual and causal Inquiry in psychosocial work environment research. Journal of Occupational Health Psychology, 1(4): 362-374, 1996.
Johnson, J.V., Stewart, W., Hall, E.M., Fredlund, P. Theorell, T. Long-term psychosocial work environment and cardiovascular mortality. American Journal of Public Health, 86; 324-331, 1996.
Trinkoff, A.M. & Storr, C.L. Incorporating auxiliary variables into probability sampling designs. Nursing Research, 46(3), 182-185, 1996.
Johnson, J.V., Hall, E.M. Class, work, and health. Pp. 247-271 in Amick, B., Levine, S., Chapman-Walsh, EDs. (Eds.) Society and Health. New York: Oxford University Press, 1995.
Johnson, J.V., Hall, E.M., et al. The psychosocial work environment of physicians. Journal of Occupational and Environmental Medicine, 37, 1151-1159, 1995.
Johnson, J.V., Hall, E.M. Social support in the work environment and cardiovascular disease. In: Shumaker, S.Czajkowski, S. (Eds.) Social Support and Cardiovascular Disease. New York: Plenum Press, 1994.
Trinkoff, A.M. & Storr, C.L. Relationship of specialty and access to substance use among registered nurses: an exploratory analysis. Drug and Alcohol Dependence, 36, 215-219, 1994.
Hall, E.M., Johnson, J.V., Tsou, T.S. Women, occupation and risk of cardiovascular morbidity and mortality, Occupational Medicine: State of the Art Reviews, 8, 1-11, 1993.
Johnson, J.V., Stewart, W. Measuring life course exposure to the psychosocial work environment with a job exposure matrix, Scandinavian Journal of Work Environment and Health, 19, 21-8, 1993.
Johansson, G., Johnson, J.V., Hall, E.M. Smoking and sedentary behavior as related to work organization. Social Science and Medicine, 32(7), 837-846, 1991.
Johnson, J.V., Johansson, G. (Eds.) The Psychosocial Work Environment: Work Organization, Democratization and Health. Amityville, N.Y: Baywood Publishing Company, Inc., 1991.
Theorell, T., de Faire, U., Johnson, J.V., Hall, E., Perski, A. Job strain and ambulatory blood pressure profiles. Scandinavian Journal of Work Environment and Health, 17, 380-385, 1991.
Johnson, J.V., Hall, E.M., Theorell, T. The combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. Scandinavian Journal of Work, Environment and Health, 15(4), 271-279, 1989.
Johnson, J.V., Hall, E.M. Job strain, work place social support and cardiovascular disease: A cross sectional study of a random sample of the Swedish working population. American
Journal of Public Health, 78, 1336-1342, 1988.
Reprinted in Steptoe, A. and Wardle, J. Psychosocial Processes and Health, Cambridge, U.K.: Cambridge University Press, 1994.
Orth-Gomer, K., Johnson, J.V. Social network interaction and mortality: A six year follow-up study of a random sample of the Swedish population. Journal of Chronic Diseases, 40, 949-957, 1987.
Celentano, D., Johnson, J.V. Stress in health care workers. Occupational Medicine: State of the Art Reviews, 2, 593-608, 1987.