Exploring the links between work-related psychosocial factors and occupational stress, occupational depression, and job anxiety among health workers in central and Southern Ethiopia: structural equation modelling

BMC Psychol. 2025 Jul 16;13(1):795. doi: 10.1186/s40359-025-03127-8.

ABSTRACT

BACKGROUND: Various theories of occupational distress and studies from high-income settings have explored associations between work-related psychosocial factors and common mental symptoms in the working population. However, studies assessing the complex relationship between the psychosocial work-related factors and common occupational mental symptoms are scarce in Ethiopia. Therefore, our study aimed to present evidence about the associations between work-related psychosocial factors and common occupational mental disorders in health workers.

METHODS: We used a cross-sectional study design in selected public hospitals in Central and Southern Ethiopia from 16th January to 28th February 2023. A total of 1426 health workers were selected using a multistage sampling technique. We collected data on endogenous variables via the Perceived Occupational Stress Scale, Occupational Depression Inventory, and Job Anxiety Scale and data on exogenous variables via psychometrically validated scales. The data were entered into Epi-Info 7, exported to SPSS, and then exported to JAMOVI 2.4.14 to perform structural equation modelling.

RESULTS: Health workers’ exposure to lower social support [β=-0.108, 95% CI: -0.158, -0.058], lower job reward [β=-0.118, 95% CI: -0.174, -0.063], higher job demands [β = 0.317, 95% CI: 0.259, 0.374], and higher work-family conflict [β = 0.357, 95% CI: 0.304, 0.409] scores significantly increased the likelihood of experiencing perceived occupational stress. Similarly, exposure to low social support [β=-0.165, 95% CI: -0.204, -0.125], low rewards [β=-0.495, 95% CI: -0.538, -0.453], high job demand [β = 0.129, 95% CI: 0.078, 0.180], higher work-family conflict higher [β = 0.287, 95% CI: 0.240, 0.335], and higher job effort [β = 0.099, 95% CI: 0.054, 0.144] were associated with increased likelihood of experiencing occupational depressive symptoms. Lower job reward score [β=-0.276, 95% CI: -0.330, -0.222], low social support [β=-0.211, 95% CI: -0.259, -0.164], and higher work-family conflict [β = 0. 373, 95% CI: 0.318, 0.428] were associated with the likelihood of experiencing job anxiety symptoms. Lower decision latitude score (β: -0.088, 95%CI: -0.159, -0.017) positively predicted job anxiety symptoms in males. Social support partially mediates the relationship between job demand and occupational stress, job demand and occupational depressive symptoms, work-family conflict and occupational stress, job reward and occupational stress, job reward and occupational depressive symptoms, and job reward and job anxiety.

CONCLUSION: Our data suggest the need to design workplace stress interventions that promote workplace social support, job rewards, and work-family balance to reduce the likelihood of experiencing occupational stress, occupational depression, and job anxiety symptoms. Workplace stress management training related to workload management, decision latitude skills, and task force allocation may be required to promote the mental well-being of health workers.

PMID:40671077 | DOI:10.1186/s40359-025-03127-8