The Job Demand-Control (JDC) model (Karasek, 1979) and the Job Demand-Control-Support (JDCS) model (Johnson, and Hall, 1988) have dominated research on occupational stress in the last 20 years. This detailed narrative review focuses on the JDC(S) model in relation to psychological well-being. It covers research from 63 samples, published in the period 1979-1997. In the review a distinction is drawn between two different hypotheses prevailing in research on the models. According to the strain hypothesis of the JDC model, employees working in a high-strain job (high demands-low control) experience the lowest well-being. The buffer hypothesis states that control can moderate the negative effects of high demands on well-being. Translating these hypotheses to the expanded JDCS model, the iso-strain hypothesis predicts the most negative outcomes among workers in an iso-strain job (high demands-low control-low social support/isolation), whereas the buffer hypothesis states that social support can moderate the negative impact of high strain on well-being. Although the literature gives considerable support for the strain and iso-strain hypotheses, support for the moderating influence of job control and social support is less consistent. The conceptualization of demands and control is a key factor in discriminating supportive from nonsupportive studies. Only aspects of job control that correspond to the specific demands of a given job moderate the impact of high demands on well-being. Furthermore, certain subpopulations appear to be more vulnerable to high (iso)strain, whereas others benefit more from high control. On the basis of the results of this review, suggestions for future research and theoretical development are formulated.

This review of the Job Demand-Control (JDC) model and the expanded Job Demand-Control-Support (JDCS) model and employees' physical health, focuses on the two prevalent views on these models. According to their view on the models researchers study different hypotheses: (a) the (iso)strain hypothesis, stating that the highest level of ill health is expected when the job is characterized by high demand and low control (and low social sup port), ot (b) the buffer hypothesis, predicting that control (and social support) can buffer the potential negative effects of high demands on physical health. It is argued that these hypotheses reflect theoretical distinct models, and that the practical implications associated with these models differ. The review of 51 studies on the JDC(S) model reveals that the “strain” hypothesis predominates in studies of all-cause mortality, cardiovascular disease (CVD) related and specific non-CVD related health outcomes. In contrast, the “buffer” hypothesis is most prevalent in research on self-reported (psycho)somatic complaints. For the strain hypothesis as well as the buffer hypothesis the results are equivocal. Working in a high (iso)strain job appears to be associated with an elevated risk for cardiovascular disease and negative pregnancy outcomes, and increased (psycho)somatic complaints. Conclusions on other physical outcomes seem premature, considering the limited number of studies. The buffer hypothesis is supported in the few studies on CVD endpoints and in some studies on (psycho)somatic complaints. A comparison of the validity of the two hypotheses is problematic, because they are mostly applied to a different set of outcomes. Furthermore, the analyses employed in the testing of the two hypotheses are of a different nature (non-linear versus linear). The main recommendation for future research is to examine the validity of the strain and the buffer hypothesis concurrently, and to further explore the nature of the relationships.

Based on two leading models in occupational stress research, the Job Demand-Control-Support model and the Michigan model, a comprehensive quality of work questionnaire, was constructed—the Leiden Quality of Work Questionnaire. The factor structure of this questionnaire was assessed and cross-validated in two subsamples of 2,000 men and women from a large sample of the Dutch working population. Analysis indicated that the questionnaire measures 11 work characteristics of Skill Discretion, Decision Authority, Task Control, Work and Time Pressure, Role Ambiguity, Physical Exertion, Hazardous Exposure, Job Insecurity, Lack of Meaning-fulness, Social Support from Supervisor and Social Support from Coworkers, and the outcome variable of Job Satisfaction in a reliable way.

Aims.  To describe job conditions, job satisfaction, somatic complaints and burnout of female East African nurses working in public and private hospitals and to determine how these well‐being outcomes are associated with job conditions.Background.  Insight into job conditions, health and well‐being status and their interrelation is virtually lacking for East African nurses.Design.  Cross‐sectional survey of 309 female nurses in private and public hospitals in Kenya, Tanzania and Uganda.Methods.  Nurses completed a survey assessing job conditions and job satisfaction (the Leiden Quality of Work Life Questionnaire – nurses version), somatic complaints (subscale of the Symptom CheckList) and burnout (Maslach Burnout Inventory).Results.  The East African nurses show high levels of somatic complaints, and nearly one‐third of the sample would be labelled as burned out. In comparison with a Western European nurses reference group, the nurses score unfavourably on job conditions that require financial investment (e.g. workload, staffing, equipment and materials). On aspects related to the social climate (e.g. decision latitude, cooperation), however, they score more favourably. In comparison with private hospital nurses, public hospital nurses score similarly on aspects related to the social climate, but worse on the other job conditions. Public hospital nurses have a lower job satisfaction than private hospital nurses, but show comparable levels of somatic complaints and burnout. Strongest correlates of low job satisfaction are low supervisor support and low financial reward. Burnout is mainly associated with high workload and inadequate information provision, whereas somatic complaints are associated with demanding physical working conditions.Conclusions.  Improvement in job conditions may reduce the high levels of burnout and somatic complaints and enhance job satisfaction in East African nurses.Relevance to clinical practice.  Efforts and investments should be made to improve the job conditions in East African nurses as they are key persons in the delivery of health care.