Effort-reward imbalance, subjective sleep quality, and inflammation in female nurses at a tertiary hospital: a pilot study

Abstract

Job stress by effort-reward imbalance (ERI) is a predictor of burnout. It is associated with inflammation and is a forerunner of distal outcomes, including mortality. Sleep quality, an important association between job stress and inflammation, has not been extensively studied. A cross-sectional study was conducted to examine the relationship between job stress, subjective sleep quality, and inflammation among female nurses. As the primary outcome measure, a composite inflammation score was constructed from five interleukins (IL-6, 8, 10, 1β, TNF-α). Among fifty participants (mean age 32 ± 7 years, work experience 105 ± 8 months), there was poor sleep quality among the high ERI group (p = 0.021). Overcommitment (OC), an intrinsic component of the ERI, was related to poor sleep quality (β = 0.21, p = 0.025). High OC (β = 2.4, p = 0.025) and increased sleep latency (β = 8.3, p = 0.027) were associated with elevated inflammation. There was a significant interaction between ERI and OC on inflammation (β = 5.186, p = 0.017) and conditional effects of ERI on OC to inflammation only in the high ERI group (p = 0.002), not in the low ERI group (p = 0.839). Composite inflammation scores from inflammatory markers may be potential indicators of adverse outcomes in burnout studies among healthcare workers.