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      Unveiling social relationships: exploring the importance of relationships as a moderator of the link between effort-reward imbalance and leader-member exchange among healthcare professionals

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          Abstract

          Objective

          Healthcare professionals are at increased risk of experiencing occupational stress and its detrimental stress-sequalae. Relevant theories that contribute to the subjective experience of occupational stress have been identified, such as the model of effort-reward imbalance (ERI) and the concept of leader-member exchange (LMX). The aim of this study was to examine how the perceived importance of social relationships at work moderates the relationship between LMX and imbalance ERI.

          Methods

          A survey was conducted among N = 1,137 healthcare professionals from diverse occupational categories in a tertiary hospital in Germany. ERI was gauged using the German version of the Effort-Reward Imbalance Questionnaire (ERI-S 10). The quality of leader-employee dyadic relationships was assessed using the German version of the Leader-Member Exchange (LMX-7). The importance of social relationships was assessed on the basis of a previously validated polarity profile.

          Results

          More than 75% of healthcare professionals reported high levels of ERI, with those involved in direct patient care particularly affected. On average, leaders rated relationship quality higher than their respective followers. Subjectively higher LMX was associated with lower ERI. This association was moderated by the perceived importance of social relationships at work. Higher subjective ratings of their importance led to a stronger association.

          Conclusion

          The study highlights the particular challenges faced in the healthcare sector. The results emphasize that the perceived importance of social relationships at work can play a key role in healthcare professionals’ job stress and underline the need for stress prevention programs that engage both leaders and followers.

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          Most cited references40

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          The Lancet Commission on global mental health and sustainable development

          The Lancet, 392(10157), 1553-1598
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            Relationship-based approach to leadership: Development of leader-member exchange (LMX) theory of leadership over 25 years: Applying a multi-level multi-domain perspective

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              Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review

              Background The adverse effects of loneliness and of poor perceived social support on physical health and mortality are established, but no systematic synthesis is available of their relationship with the outcomes of mental health problems over time. In this systematic review, we aim to examine the evidence on whether loneliness and closely related concepts predict poor outcomes among adults with mental health problems. Methods We searched six databases and reference lists for longitudinal quantitative studies that examined the relationship between baseline measures of loneliness and poor perceived social support and outcomes at follow up. Thirty-four eligible papers were retrieved. Due to heterogeneity among included studies in clinical populations, predictor measures and outcomes, a narrative synthesis was conducted. Results We found substantial evidence from prospective studies that people with depression who perceive their social support as poorer have worse outcomes in terms of symptoms, recovery and social functioning. Loneliness has been investigated much less than perceived social support, but there is some evidence that greater loneliness predicts poorer depression outcome. There is also some preliminary evidence of associations between perceived social support and outcomes in schizophrenia, bipolar disorder and anxiety disorders. Conclusions Loneliness and quality of social support in depression are potential targets for development and testing of interventions, while for other conditions further evidence is needed regarding relationships with outcomes. Electronic supplementary material The online version of this article (10.1186/s12888-018-1736-5) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Rebecca.Erschens@med.uni-tuebingen.de
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 August 2024
                10 August 2024
                2024
                : 24
                : 2169
                Affiliations
                [1 ]Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, ( https://ror.org/03a1kwz48) 72076 Tuebingen, Baden-Wuerttemberg Germany
                [2 ]GRID grid.6582.9, ISNI 0000 0004 1936 9748, Department of Anesthesiology and Intensive Care Medicine, , University Hospital Ulm, Ulm University, ; 89070 Ulm, Baden-Württemberg Germany
                [3 ]German Center for Mental Health (DZPG), Tübingen, Germany
                [4 ]GRID grid.411544.1, ISNI 0000 0001 0196 8249, Institute of Occupational and Social Medicine and Health Services Research, , University Hospital Tübingen, ; 72076 Tuebingen, Baden-Wuerttemberg Germany
                [5 ]Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, ( https://ror.org/032000t02) 89081 Ulm, Baden-Württemberg Germany
                [6 ]Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg, 39120 Magdeburg, Sachsen-Anhalt Germany
                Article
                19652
                10.1186/s12889-024-19652-x
                11316433
                39127619
                86a508cc-a1f1-4ff3-a1f9-eb43d3c311cc
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 24 August 2023
                : 30 July 2024
                Funding
                Funded by: Universitätsklinikum Tübingen (8868)
                Categories
                Research
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                © BioMed Central Ltd., part of Springer Nature 2024

                Public health
                Public health

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