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

• Published in: BMC public health Vol. 24; no. 1; pp. 2169 - 13
• Main Authors: Erschens, Rebecca, Armbruster, Ines, Adam, Sophia Helen, Rapp, Felicitas, Braun, Lisa, Schröpel, Carla, Zipfel, Stephan, Rieger, Monika A, Gündel, Harald, Rothermund, Eva, Junne, Florian
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10-08-2024; BioMed Central; BMC
• Subjects: Adult; Analysis; Employee incentives; Female; Germany; Health aspects; Health care; Health Personnel - psychology; Humans; Hypotheses; Interpersonal Relations; Job stress; Leader-member exchange; Leadership; Male; Medical personnel; Middle Aged; Nurses; Occupational health; Occupational stress; Occupational Stress - psychology; Pandemics; Prevention; Professionals; Psychological aspects; Psychological stress; Reinforcement; Reward; Risk factors; Social aspects; Social interactions; Social support; Surveys and Questionnaires; Working conditions; Germany
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-19652-x

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.
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.
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.
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.