Effort–reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study

Objective: The aim of this study was to test the reliability and validity of the Chinese version of the 23-item effort–reward imbalance (ERI) questionnaire and to analyze its association with job dissatisfaction in a sample of Chinese healthcare workers. Methods: A self-reported survey was conducted, in university hospitals of China, among 192 male and 608 female healthcare workers. Results: Appropriate internal consistencies of the three scales: effort, reward, and overcommitment, were obtained. Exploratory factor analysis replicated the theoretically assumed structure of the ERI construct in men and women. Evidence of criterion validity was obtained from cross-correlations of the scales and from their correlations with gender, education and job dissatisfaction. Finally, all three scales were associated with an elevated odds ratio of job dissatisfaction, and the effect was strongest for the ERI ratio as predicted by theory. Conclusion: Based on the results of this study the Chinese version of the ERI questionnaire is considered a reliable and valid instrument for measuring psychosocial stress at work. It is applicable to Chinese working populations and, in particular, to the healthcare sector.