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Work-Health Balance - A new construct to explain workers’ well being after

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Poster · May 2015

DOI: 10.13140/RG.2.1.4213.5769

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Andrea Gragnano Massimo Miglioretti

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 Andrea Gragnano1, Massimo Miglioretti1, Silvia Simbula1, Angela De Boer2
1 Department of Psychology, Università degli Studi di Milano Bicocca - Milan, Italy
2 Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam, Netherlands

Contact: a.gragnano@campus.unimib.it

The Theory
Background
In the developed countries an increased age of retirement enlarged the number of active elderly workers. Moreover, the improvement of medical treatment and the diffusion of rapid
screening tests increased the number of workers that overtake the acute phase of severe diseases as cancer or cardiovascular diseases that in the past definitely compromised work
abilities. These two elements changed the labour market, boosting the proportion of workers with a long-standing health problem or disability (LSHPD) due to aging or illness [1]. For these
workers the challenge is to maintain work activity, preserve it in a good quality, and take care of their health. The OECD [2] highlighted that too many workers leave the labour market
permanently due to health problems or disability and too few people with reduced work capacity succeed in remain employed with an unemployment rate twice as high for people
with disabilities as for those without in the OECD countries. In line with this, the ENWHP [3] called for a paradigm shift in the research on workplace health promotion from attention to the
current employability to a focus on a sustained and prolonged employability of workers with LSHPD.
In some life circumstances (e.s.: workers with LSHPD or elderly workers) health became a central issue. In these situations, the worker may expert incompatibility between the work
demands and the health needs, incompatibility that prevent from a good and durable working experience. In the literature there exists no theoretical construct nor measurement
instrument specifically investigating the balance between the health and work domains.

Work Health Balance (WHB) - Definition

From the literature of work-life balance [4] we defined the Work-Health Balance as:
WHB is a state in which the worker feels to be able to effectively balance health and work needs, considering the management attention
to the employees’ health and the perception of compatibility between the personal health situation and the job characteristics.
WHB is a personal dimension considering several elements that shape the worker representation of the situation, of the personal possibilities, of how the things are going, and how they
can evolve

The WHB questionnaire - WHBq Final EFA and items kept after Rasch (in bold)
Theoretical dimensions Explorative factorial analysis Scales and items
Work-Health incompatibility (WHI)
1 2 3

We believe, a questionnaire measuring WHB have to
measure two kinds of dimensions:
1) Perception of compatibility between work and health.
This perception becomes relevant when the health
domain gains importance and it is a consequence of the
evaluation of the personal abilities to manage the
situation, of the present work situation, and of the health
requests;
2) Perception of how much the working environment is
favourably disposed toward the personal health needs, of Health Climate (HC) = Management behaviour perceived
how much effort the working environment is disposed to do as genuinely interested in the employees’ health.
to accomplish the worker’s health needs.
It is constituted by the perception of the work flexibility that
may eventually be used for work adjustment, of the support Each subscale analysed with the partial credit model [5] a
from the direct supervisor, and of the evaluation of the
degree of attention to the employees’ health on behalf of
management.
Items generation
The development of the WHBq items followed a four step
procedure (DeVellis, 1991) which involved three researchers, differently between male and female, and between
326 questionnaires collected through the Internet. All the 1. If you really want to take care of your health, you have to neglect
.55
your job
respondents were workers at the moment of the 2. Your job is an hindrance to your health .70
assessment and 31% of them had suffered from a serious 3. You can not adequately take care of your health for the time you
.83
disease or major injury. have to dedicate to the job
4. Sometimes it happens that you have to miss work activities or that
The EFA removed 10 items and revealed a three-factor you can not complete all the job tasks due to the time you have to .51
structure: spend for your health
Work-Health Incompatibility (WHI) = How much the present 5. Your job lets you take care of your health -.69
6. It is quite easy for you to balance work commitments with your
job is an obstacle to the management of health needs; health need
-.74
External Support (ES) = Work flexibility and supervisor 7. You find it difficult to take care of your health because you are
.68
support for health reasons; constantly thinking about your work
8. You do not have the energy to take care of your health because of
.80
your job
9. Your work obligations make it difficult for you to take care of your
.78
health problem
Rasch analyses 10. Your work takes up time that you would have liked to spend for
.76
your health
Health climate (HC)
Rasch analysis for polytomous items. 11. In your workplace management acts quickly to correct
.86
Rasch analyses reduced the number of items at 17. All the problems/issues that may interfere with employees’ health
scales were characterised by unidimensionality, good 12. Senior management acts decisively when concerns about health
emerge between employees
.86
adherence to the Rasch measurement specifications, and
an acceptable level of person reliability index (.72 - .90)
13. The health of staff is a priority for the organization
14. Senior management clearly considers the health of employees to
.87
.86
and items distribution. All the items did not function be of great importance
15. Senior management considers employee health to be as important
as productivity
.86

expert in the field of work and health, and one graduate workers that have had a severe disease or injuries and 16. In my organization, the health prevention involves all levels of the
.95
student. those who have had not. organization
17. Employees are encouraged to become involved in safety and
.87
Dimensions definition > Research of similar instruments
> Evaluation and selection of the items collected >
WHB index health matters
18. Employees contributions to resolving occupational health and
.85
Adaptation and development of new items WHB = [(External Support + Health Climate)/2] – Work safety concerns in the organization are listened to
19. In your organization it is usual to consult unions and workers’
The first version of the questionnaire consisted of 38 items. Health Incompatibility representatives
.59
20. Information about health prevention is always brought to your
.82
attention by your manager/supervisor

WHB and well-being at work External support (ES)

21 In your workplace, when someone has health problem he / she can
.56
determine where to put his /her time and energies at work
Hypothesis 22. Your supervisor permits you to arrive and depart from work when
you want for health reasons
.82
We expect a good Work Health Balance to be positively related to job satisfaction and work engagement and negatively 23. You are free to work the hours when you feel better .85
related to emotional exhaustion, psychological distress, presenteeism, and workhaolism 24. There is no flexibility in your schedule, neither for health issues -.54
25. It is O.K. with your employer if work at home for health reasons .65
Analysis 26. Your supervisor understands your health needs
27. Your supervisor listens when you talk about your health
.66
.52
On the same sample used for the questionnaire development (326 workers) we calculated the partial correlations 28. Your supervisor acknowledges that you may have specific
.64
necessity for your health status
between the WHB and its scales and the other variables indicating the quality of life and working life, controlling for the
effects of gender, and the working hours.
Results
Variables Correlation of the WHBq scales and the WHB index, with
Job satisfaction (JS), measured with a single item asking respondents to rate satisfaction with their job over-all on the external variables
a 5-point scale P JS WE EE WkE WkC GHQ
Work engagement (WE), measured with the short version of the Utrecht Work Engagement Scale (UWES-9);
WHI .36*** -.37*** -.30*** .43*** .43*** .41*** .39***
Emotional exhaustion (EE), measured with the emotional exhaustion scale of the Maslach Burnout Inventory
General Survey (MBI-GS); ES -.28*** .34*** .25*** -.36*** -.12 .-12 -.25***
Presenteeism (P), was measured with a single item; HC -.31*** .44*** .38*** -.35*** -.07 -.17* -.32***
Workaholism, was measured with the two scales of the Ductch Work Addiction Scales namely, Working WHB -.42*** .48*** .39*** -.49*** -.32*** -.37*** -.43***
excessively (WkE) and Working compulsively (WkC); Note. * p < .05 and *** p < .001
General psychological health (GHQ), was measured with the 12-item General Health Questionnaire. Our hypothesis were confirmed

Limitations
The collection of data occurred through a web survey. The use of Internet for surveys can be affected by selection bias. Important variables that may be related with
the WHB, as the turnover intention or absenteeism were not considered in this research. Finally, the use of cross-sectional data prevents to establish causal relationships
with related antecedents and consequences.

Research and pratical implications

Nowadays, the relation between health and job is a central issue for HRM. The WHB describes the connections between health and work from the worker’s perspective. We
developed a questionnaire measuring the WHB that showed good psychometric characteristics with strong and theoretically consistent relations with important and well-known
dimensions. Moreover, we used a mix of the classic test theory with item response theory that ensure a deep level of analyses of the questionnaire. With the WHBq we offer a short
tool to test the theory of the Work-Health Balance and an instrument that helps researchers and professionals in the management of elderly workers and workers with LSHPD.

References
[1] EUROSTAT. (2011). hlth_dlm040 - Population by type of disability, sex, age and labour status [Table]. Retrived from http://ec.europa.eu/eurostat/web/health/disability/data/database;
[2] OECD (2010). Sickness, Disability and Work: Breaking the Barriers: A Synthesis of Findings across OECD Countries. OECD Publishing;
[3] ENWHP (2013). The Brussels Declaration on Workplace Health Practices for Employees with Chronic Illness. Available at: http://www.enwhp.org/fileadmin/user_upload/pdf/Brussels_Declaration.pdf;
[4] Keeney, J., Boyd, E. M., Sinha, R., Westring, A. F., & Ryan, A. M. (2013). From “work-family” to “work-life”: Broadening our conceptualization and measurement. Journal of Vocational Behavior, 82(3), 221–237;
[5] Masters, G.N. (1982). A Rasch model for partial credit scoring. Psychometrika, 47, 149–174.

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