Abstract
Background: The effort-reward imbalance (ERI) model is widely used in job stress research. However, few studies using this model have been conducted in developing countries. This study tested the extrinsic and intrinsic hypotheses regarding the burnout of healthcare workers in China with the ERI model. Method: Job stress was assessed by Siegrist's ERI questionnaire, and burnout was evaluated by the Maslach Burnout Inventory-General Survey (MBI-GS). A total of 1,505 effective respondents were included in the final study. Multiple and hierarchical linear regression was used to analyze the association between components in the ERI model and burnout. Results: Emotional exhaustion and cynicism were positively correlated with ERI and overcommitment. Professional efficacy was positively related to ERI but not to overcommitment. ERI was the determining factor of emotional exhaustion and cynicism. Overcommitment moderated the relationship between ERI and emotional exhaustion and between ERI and cynicism. Conclusion: Changing workplace conditions and increasing personal resilience might alleviate burnout among hospital workers in China. The links between professional efficacy and stressful work environment need further exploration.