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Understanding and Preventing Work-Related Stress: From Theoretical Models to Medical Practice

Work-related stress is a public health issue that increasingly affects professionals worldwide. To grasp and mitigate it, it’s vital to delve into the theoretical models that unravel its mechanisms and impacts.

Estimated reading time : 3 minutes

The first model, proposed by Henri Laborit in 1958, likens human reactions to stress to those of animals who, when confronted with danger, may flee, freeze, or fight. This analogy highlights the physiological impact of stress, characterized by the secretion of adrenaline and subsequent bodily reactions.

The Karasek Model

In 1970, Robert Karasek expanded this view with his Demand-Control-Support (DCS) model. He suggests that professional stress is caused by an imbalance between job demands (psychological demands) and the ability to exercise control over one’s work environment (decisional latitude). This model is further refined by the notion of social support, which serves as a buffer against stress. Karasek identifies four work scenarios:

  • Strained: high demand and low control, high stress risk.
  • Active: high demand and high control, moderate stress risk.
  • Relaxed: low demand and high control, low stress.
  • Passive: low demand and low control, moderate stress risk due to potential demotivation.

However, Karasek’s model isn’t without its critics. Some argue that demand and control may independently affect health, and the impact of social support can vary among individuals and circumstances.

The Siegriest Model

Johannes Siegrist’s model, introduced in 1996, focuses on job equity, meaning the balance or imbalance between the effort made by employees and the rewards they receive. Siegrist is particularly interested in the consequences of a perceived imbalance deemed unfair, leading to chronic stress and associated health problems. Three critical situations are identified:

  • An unclear employment contract or few alternative job opportunities.
  • Acceptance of an imbalance in anticipation of better future conditions.
  • Excessive commitment in response to work overload.

Epidemiological studies, such as Kouvonen’s in 2006, substantiate Siegrist’s model, showing that those with a high effort-reward imbalance are significantly more likely to develop risk factors for cardiovascular diseases.

Ultimately, the combination of Karasek and Siegrist’s models offers more robust predictive tools. The combined analysis of these two models helps identify populations at risk for specific health problems related to stress, as demonstrated by the INSERM study that links work stress to a significant portion of myocardial infarction cases.

In conclusion:

Therefore, it is imperative for occupational health physicians and healthcare professionals to rely on these models to devise targeted preventative interventions. This involves accurate assessment of work environments and promoting an organizational culture that values balance, individual control, and support within the workplace.

Philippe Casanova

Specialist in occupational medicine and forensic medicine.