Job Strain, Effort-Reward Imbalance and Mental Distress: A study of occupations in general medical practice

There is increasing evidence to support the predictive power of social epidemiological models such as Effort-Reward Imbalance (Siegrist, 1996) and the Job-Strain Model (Karasek, and Theorell, 1990) for explaining occupational stress, although it has been suggested that the models may have distinctive contributions towards explaining work stress in specific work settings. Alternatively, it has been suggested that the explanatory power of the different models might be enhanced if they were combined. The aim of this paper is to explore these questions by examining the power of the two different models both separately and in combination for explaining job satisfaction and mental distress in general medical practice. This analysis was based on data collected from a postal survey of the members of staff (N = 1089, response rate = 70%) of 81 practices, which were randomly selected from all general practices in the National Health Service Executive South East region. The results show that while both models were predictors of mental distress and job satisfaction the models that combined different dimensions were the strongest predictors.