Effort-Reward Imbalance and Its Effects on Satisfaction With Working Conditions and Sleep-Related Problems: Comparison of Nurses and Other Occupations.

Purpose This study aimed to compare effort-reward imbalance (ERI) among registered nurses, social workers, and elementary school teachers, and to analyze the effects of ERI on satisfaction with working conditions and sleep-related problems. Design A secondary data analysis was conducted using cross-sectional data from the Korean Working Conditions Survey collected in 2017. The study sample included 276 registered nurses, 97 social workers, and 229 elementary school teachers. Methods The effort index was measured using two dimensions (work intensity and working time quality) with seven subdimensions. The reward index consisted of three dimensions (social support, earning, and prospects) with five subdimensions. The ERI index was computed by dividing the average effort score by the average reward score. Linear or logistic regression analysis was conducted to compare efforts, rewards, and ERI among the three occupations and to examine the effects of ERI on satisfaction and sleep-related problems. Findings Nurses had a significantly higher effort score than the other two groups. However, nurses had a lower reward score than elementary school teachers, but a higher score than social workers. The highest ERI index was found among nurses (0.47 ± 0.16), followed by social workers (0.39 ± 0.30) and elementary school teachers (0.30 ± 0.15). All three occupations showed an inverse relationship between ERI and satisfaction with working conditions and positive relationships between ERI and sleep-related problems. Conclusions The high ERI (i.e., more effort relative to reward) perceived by nurses was associated with diminished satisfaction and increased sleep-related problems. Clinical relevance To attract future generations to nursing as a career choice and to ensure a sustainable nurse workforce, the nurse-perceived ERI should be decreased by reducing work demands and increasing both monetary and nonmonetary rewards.